Department of Ophthalmology, University of Erlangen-Nürnberg, Schwabachanlage, Erlangen, Germany.
Cornea. 2012 Aug;31(8):887-92. doi: 10.1097/ICO.0b013e31823f8f7a.
To evaluate the efficacy and safety of combined feeder vessel coagulation and topical antiangiogenic therapy using bevacizumab in the treatment of mature corneal blood vessels.
Sixteen eyes of 16 patients with mature corneal neovascularization (NV) due to different underlying corneal diseases underwent fine-needle feeder vessel coagulation by diathermy and were treated postoperatively for up to 4 weeks with topical bevacizumab eye drops (containing 5 mg/mL bevacizumab) 5 times a day. Nine patients received an additional subconjunctival bevacizumab injection at the time of cautery.
The mean duration of follow-up was 276 ± 147.3 days (range, 29-464 days). Regression of the feeder vessel was observed in 14 eyes. The vascularized area was reduced significantly (P < 0.05). Combined subconjunctival and eye drop antivascular endothelial growth factor treatment was significantly more effective in reducing the vascularized area compared with antivascular endothelial growth factor eye drop therapy alone (P < 0.05). Five patients (5 eyes) needed a second treatment. Thirteen patients (13 eyes) receiving topical bevacizumab treatment combined with feeder vessel coagulation showed stable visual acuity. Two patients had improved visual acuity. One patient had enlarged area of lipid keratopathy despite successful treatment of corneal NV and thus decreased visual acuity. Overall, there was a nonsignificant improvement of best-corrected visual acuity (P > 0.05).
In this pilot study, fine-needle feeder vessel coagulation combined with topical bevacizumab application for treatment of mature corneal NV seemed to be a well-tolerated new treatment option to regress corneal NV. This may not only improve corneal transparency but also "preconditions" such a cornea for future keratoplasty.
评估电凝联合贝伐单抗局部抗血管生成治疗成熟角膜血管的疗效和安全性。
16 例（16 只眼）不同病因导致的成熟角膜新生血管（NV）患者接受细针 feeder 血管电凝，并在术后 4 周内每天滴用 5 次含有 5mg/ml 贝伐单抗的贝伐单抗眼药水。9 例患者在电凝时同时接受结膜下贝伐单抗注射。
平均随访时间为 276±147.3 天（范围 29-464 天）。14 只眼观察到 feeder 血管消退，血管化面积明显减少（P<0.05）。与单纯眼内抗血管内皮生长因子治疗相比，结膜下和眼内联合抗血管内皮生长因子治疗更能显著减少血管化面积（P<0.05）。5 例患者（5 只眼）需要第二次治疗。13 例（13 只眼）接受贝伐单抗联合 feeder 血管电凝治疗的患者视力稳定。2 例患者视力提高。1 例患者尽管成功治疗了角膜 NV，但脂质角膜病变面积增大，视力下降。总体而言，最佳矫正视力无显著改善（P>0.05）。
在这项初步研究中，细针 feeder 血管电凝联合局部贝伐单抗治疗成熟角膜 NV 似乎是一种耐受性良好的新治疗选择，可以使角膜 NV 消退。这不仅可以提高角膜透明度，还可以为未来的角膜移植“预处理”角膜。
