title: Corneal endothelial safety following subconjunctival and intrastromal injection of bevacizumab for corneal neovascularization.
abstract: The purpose of this study is to determine the effect on endothelial cell density and morphology of combined subconjunctival and intracorneal injection of bevacizumab for the treatment of corneal neovascularization (NV). The charts and specular microscopy images of ten consecutive patients with corneal NV, who received combined subconjunctival+intracorneal injections of bevacizumab were reviewed. Patients received three injections of bevacizumab 25 mg/mL (1.25 mg/0.05 mL subconjunctival and 1.25 mg/0.05 mL intrastromal) 4-6 weeks apart. Endothelial cell counts (ECCs) and morphological changes were assessed by non-contact specular microscopy performed at baseline, 1 month after each injection and at 3 and 6 months after the last injection. There were no significant changes in ECCs (p = 0.663), coefficient of variation (p = 0.076), percentage of hexagonal cells (p = 0.931) or mean corneal thickness (p = 0.462) from pre-injection values to the 6-month follow-up values. There were no intraoperative or postoperative complications. In our series, the use of combined subconjunctival and intracorneal bevacizumab did not cause any decrease in ECCs or morphological alterations up to 6 months after the last of three injections. Further studies are required to confirm long-term safety in a larger sample population with longer follow-up, as well as the ideal dose, route of administration and frequency of bevacizumab administration.
authors.affiliation: Department of Ophthalmology, Toronto Western Hospital, University of Toronto, 399 Bathurst Street, East Wing 6E 401, Toronto, ON, M5T 2S8, Canada, drlichtinger@yahoo.com.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Lichtinger
authors.forename: Sonia N
authors.initials: SN
authors.lastname: Yeung
authors.forename: Peter
authors.initials: P
authors.lastname: Kim
authors.forename: Maoz D
authors.initials: MD
authors.lastname: Amiran
authors.forename: Uri
authors.initials: U
authors.lastname: Elbaz
authors.forename: Allan R
authors.initials: AR
authors.lastname: Slomovic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D000068258:Bevacizumab; D016510:Corneal Neovascularization / Q000188:drug therapy*; D042783:Endothelial Cells / Q000166:cytology; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D056965:Injections, Intraocular; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab