
To evaluate and compare the efficacy of subconjunctival bevacizumab injections alone, photodynamic therapy alone and combined treatments for reduction of corneal neovascularization.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.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.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.
Adult, Aged, 80 and over, Male, Photosensitizing Agents, Porphyrins, Verteporfin, Angiogenesis Inhibitors, Middle Aged, Combined Modality Therapy, Bevacizumab, Treatment Outcome, Photochemotherapy, Image Processing, Computer-Assisted, Humans, Corneal Neovascularization, Female, Prospective Studies, Injections, Intraocular, Aged, Follow-Up Studies
Adult, Aged, 80 and over, Male, Photosensitizing Agents, Porphyrins, Verteporfin, Angiogenesis Inhibitors, Middle Aged, Combined Modality Therapy, Bevacizumab, Treatment Outcome, Photochemotherapy, Image Processing, Computer-Assisted, Humans, Corneal Neovascularization, Female, Prospective Studies, Injections, Intraocular, Aged, Follow-Up Studies
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