title: [Corneal neovascularisation treatments compared: Subconjunctival bevacizumab injections and/or photodynamic therapy].
abstract: OBJECTIVE
  To evaluate and compare the efficacy of subconjunctival bevacizumab injections alone, photodynamic therapy alone and combined treatments for reduction of corneal neovascularization.
  
  
  METHODS
  This study was conducted as a prospective case series. A total of seven eyes of 7 patients with corneal neovascularization caused by ocular surface disorders including fungal infectious keratitis and penetrating keratoplasty were included in the study. Patients were randomized into the three following groups: patients in group A received a single subconjunctival injection of 10mg (0.4mL) of bevacizumab, patients in group B were treated with photodynamic therapy with verteporfin (6mg/m(2)) to the neovascularized area and those in group C received a subconjunctival injection of bevacizumab and photodynamic therapy 7 days later. Morphological changes in neovascularization were evaluated over 6 months using slit-lamp biomicroscopy and digital corneal photography. A computer-assisted semi-automatic analysis of the area of corneal neovascularization was performed with Image J software.
  
  
  RESULTS
  Recession of corneal vessels was observed in all eyes at 1 month post-treatment. The neovascularized surface area in all groups combined showed a decrease in the first month after treatment and this decrease continued up to the 6th month. The surface area of corneal neovascularization decreased by 34.05±8.28% in group A (subconjunctival injection of bevacizumab), by 42.06±28.36% in group B (photodynamic therapy with verteporfin) and by 51.67±18.93% in group C (combined subconjunctival injection of bevacizumab and photodynamic therapy). A combined treatment consisting of a subconjunctival injection followed by a PDT session 7 days later might be more effective for the treatment of corneal neovascularisation. No serious local or systemic adverse events were observed.
  
  
  CONCLUSIONS
  Our medium-term results suggest that combined subconjunctival injection of bevacizumab and photodynamic therapy with verteporfin might be used safely and effectively to reduce corneal neovascularization surface. This combined therapy may show a tendency toward greater efficacy than the individual monotherapies. Controlled prospective randomized multicentric trials with a larger sample size are necessary to assess long-term efficacy and to confirm these results.
authors.affiliation: Service d'ophtalmologie, hôpital de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France. Electronic address: jeremie.hamdan@hotmail.fr.
authors.forename: J
authors.initials: J
authors.lastname: Hamdan
authors.affiliation: Service d'ophtalmologie, hôpital de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
authors.forename: M
authors.initials: M
authors.lastname: Boulze
authors.affiliation: Service d'ophtalmologie, hôpital Nord, AP-HM, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: A
authors.initials: A
authors.lastname: Aziz
authors.affiliation: Service d'ophtalmologie, centre hospitalier du Pays d'Aix, avenue des Tamaris, 13616 Aix-en-Provence, France.
authors.forename: G
authors.initials: G
authors.lastname: Alessi
authors.affiliation: Service d'ophtalmologie, hôpital de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
authors.forename: L
authors.initials: L
authors.lastname: Hoffart
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D016510:Corneal Neovascularization / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D056965:Injections, Intraocular; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome; D000077362:Verteporfin
chemical_list: D020533:Angiogenesis Inhibitors; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D000068258:Bevacizumab
keywords: Angiogenesis inhibitor; Corneal neovascularization; Inhibiteur de l’angiogenèse; Néovascularisation cornéenne; Photodynamic therapy; Photothérapie dynamique