title: Anti-VEGF therapy with bevacizumab for anterior segment eye disease.
abstract: OBJECTIVE
  To review the current literature concerning the use of bevacizumab in treating neovascular disorders affecting the anterior segment ocular structures.
  
  
  METHODS
  The authors reviewed the literature on anti-vascular endothelial growth factor (VEGF) therapy with bevacizumab for various anterior segment neovascular disorders that was indexed in MEDLINE (up to January 2011).
  
  
  RESULTS
  Response to bevacizumab anti-VEGF therapy is variable, based on the amount of scarring, the chronicity and extent of corneal neovascularization, the disease process, and the medication formulation and its route of administration. Anti-VEGF agents are especially effective when administered early, before anatomical changes, such as corneal neovascularization and/or angle closure, are established. Neovascularization can recur if the ischemic or inflammatory process is not reversed, so eyes with long-standing diseases, such as autoimmune disorders that involve ongoing inflammation and VEGF production, seem to be less responsive to bevacizumab anti-VEGF therapy. For established neovascularization, combining anti-VEGF agents with the removal of established vessels may be more effective than anti-VEGF therapy alone. Subconjunctival bevacizumab may be more appropriate for focal, deep, and peripheral neovascularization, whereas diffuse superficial neovascularization with central corneal involvement may be best treated via topical application.
  
  
  CONCLUSIONS
  Besides the widely accepted use of bevacizumab in cancer therapy and chorioretinal neovascularization, the initial, striking, short-term response and patients' high tolerance of local bevacizumab therapy offer encouraging results for the potential role of anti-VEGF agents in treating anterior segment neovascular disorders. Controlled prospective trials are needed to establish the long-term safety, efficacy, and dosing guidelines for the use of anti-VEGF agents in anterior segment neovascularization.
authors.affiliation: Department of Ophthalmology, Poostchi Ophthalmic Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 7134997446.
authors.forename: Hamid
authors.initials: H
authors.lastname: Hosseini
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Nowroozzadeh
authors.forename: Ramin
authors.initials: R
authors.lastname: Salouti
authors.forename: Mahmood
authors.initials: M
authors.lastname: Nejabat
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000818:Animals; D000869:Anterior Eye Segment; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D016510:Corneal Neovascularization / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005128:Eye Diseases / Q000188:drug therapy*; D006801:Humans; D009389:Neovascularization, Pathologic / Q000188:drug therapy*; D011817:Rabbits; D042442:Vascular Endothelial Growth Factors / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042442:Vascular Endothelial Growth Factors; D000068258:Bevacizumab