title: [The influence of VEGF inhibitors on corneal endothelium after injection into the anterior chamber in a porcine eye model].
abstract: BACKGROUND
  The injection of antiangiogenic agents, such as ranibizumab (Lucentis®) and bevacizumab (Avastin®) into the anterior chamber of the eye represents a suitable alternative for treating neovascular glaucoma by reducing intraocular pressure.
  
  
  OBJECTIVE
  As the antiangiogenic substances are in direct contact with the sensitive corneal endothelium, the aim of this study was to show the effects of intracameral injection of ranibizumab and bevacizumab on this cell layer.
  
  
  METHODS
  Each injection consisted of 50 µl containing either ranibizumab (0.5 mg/0.05 ml), bevacizumab (1.25 mg/0.05 ml) or triamcinolone containing benzyl alcohol (2 mg/0.05 ml) which was used as the control group. These compounds were injected into the anterior chamber of pig eyes. Afterwards the corneas were dissected, fixed, examined by a scanning electron microscopy and evaluated according to a specified score. Assessment of the endothelium was carried out by evaluating the condition of microvilli, cell borders, cell surface and cell pattern. The findings were compared to untreated corneas and those injected with 50 µl of balanced salt solution (BSS).
  
  
  RESULTS
  The corneal endothelium exposed to the antiangiogenic substances showed only minor changes in comparison to the controls treated only with BSS. Also seen during this research was the irreversible cell damage in the control group using triamcinolone.
  
  
  CONCLUSIONS
  Ranibizumab and bevacizumab have no damaging effects on the corneal endothelium when used in the anterior chamber. They can be administered as an intracameral injection for the treatment of rubeotic secondary glaucoma. Triamcinolon containing benzyl alcohol causes severe damage to the endothelial cells of the cornea by direct contact.
authors.affiliation: Augenabteilung, St. Franziskus-Hospital Münster, Hohenzollernring 74, 48145, Münster, Deutschland, ankewilhelm@gmx.net.
authors.forename: A
authors.initials: A
authors.lastname: Wilhelm
authors.forename: R
authors.initials: R
authors.lastname: Sietmann
authors.forename: U
authors.initials: U
authors.lastname: Wilhelm
authors.forename: T
authors.initials: T
authors.lastname: Hammer
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D000867:Anterior Chamber; D000068258:Bevacizumab / Q000008:administration & dosage / Q000627:therapeutic use*; D055954:Corneal Endothelial Cell Loss / Q000139:chemically induced; D004195:Disease Models, Animal; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000473:pathology; D015355:Glaucoma, Neovascular / Q000188:drug therapy*; D056965:Injections, Intraocular; D007429:Intraocular Pressure / Q000187:drug effects*; D000069579:Ranibizumab / Q000008:administration & dosage / Q000627:therapeutic use*; D013552:Swine; D014221:Triamcinolone / Q000008:administration & dosage / Q000009:adverse effects; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A; D014221:Triamcinolone; D000068258:Bevacizumab; D000069579:Ranibizumab