Recurrence of corneal neovascularization associated with lipid deposition after subconjunctival injection of bevacizumab.
OBJECTIVE
To report 7 cases of recurrent corneal neovascularization (NV) and lipid deposition after subconjunctival injection of bevacizumab for the treatment of corneal NV-induced lipid keratopathy.


METHODS
We conducted a prospective interventional case series that included 20 eyes of chronic lipid keratopathy that received bevacizumab injection for the treatment of corneal NV and lipid deposition, including 7 eyes with recurrent corneal NV and lipid deposition after ceasing treatment. Repeated subconjunctival injections of bevacizumab were performed in 5 patients with recurrence. Penetrating keratoplasty was performed in 1 patient who had severely recurrent lipid deposition. Clinical presentation of corneal NV and lipid deposition, best-corrected visual acuity, and complications after treatments were recorded.


RESULTS
Bevacizumab inhibited corneal NV and lipid depositions in 19 patients. Seven of the 20 patients (35%) had different patterns of recurrence of corneal NV/lipid deposition 6 to 15 months after discontinuing treatment. Five of the 7 patients in whom corneal NV/lipid deposition was recurrent received another course of repeated bevacizumab treatments. Three eyes had partial response to the second course of treatment. Two eyes had too short re-treatment course to have conclusions. One patient who received penetrating keratoplasty had successful result after surgery.


CONCLUSIONS
Corneal NV and lipid deposition may recur after ceasing the subconjunctival bevacizumab injections for lipid keratopathy. Some patients respond at least partially to repeated injections.
*Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan †Center for Corneal Tissue Engineering and Stem Cell Biology, National Taiwan University Hospital, Taipei, Taiwan.
Hsiao-Sang
HS
Chu
Ta-Ching
TC
Chen
Fung-Rong
FR
Hu
Wei-Li
WL
Chen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D016510:Corneal Neovascularization / Q000188:drug therapy*; D005260:Female; D006801:Humans; D056965:Injections, Intraocular; D052439:Lipid Metabolism Disorders / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D017211:Treatment Failure
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab