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The use of subconjuntival bevacizumab for treatment of the corneal neovascularisation

The use of subconjuntival bevacizumab for treatment of the corneal neovascularisation. Studený P., Siveková D., Vokrojová M., Farkaš A. Department of Ophthalmology, 3rd Medical Faculty, Charles University, Prague, Czech Republic.

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The use of subconjuntival bevacizumab for treatment of the corneal neovascularisation

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  1. The use of subconjuntival bevacizumab for treatment of the corneal neovascularisation Studený P., Siveková D., Vokrojová M., Farkaš A. Department of Ophthalmology, 3rd Medical Faculty, Charles University, Prague, Czech Republic The authors have no financial interest in the presentation material

  2. Purpose To evaluate the effect of subconjunctival bevacizumab on corneal neovascularization

  3. Materials and methods Prospective study – under termis and conditions of ethical committee of 3rd medical faculty, Charles university, Prague, all patients were fully informed and signed a consent form 17 eyes of 17 consecutive adult patients (8 men, 9 women) Mean age 59 years (25 – 81) Follow up time 6 months

  4. Indications in our study Serious corneal NV with decreasing of the corneal transparency (Leucoma corneae with NV - ulcus, rejection, chemical burn) Patients after corneal transplantation, where the corneal NV increases the risk of rejection Patients with serious corneal neovascularisation before planned PKP

  5. Aplication and clinical evaluation Aplication • Subconjunctival injection of bevacizumab (0,75 mg - 0,03 ml) • Usually 2 - 4 subconjuntival blebs in place of maximal neovascularization Clinical evaluation • Complete ophthalmic examination including BCVA, IOP, biomicroscopy, fundus - before, after 1 week, 1,2,3,6 month • Digital photographs of the cornea • Corneal pattern for grading 96 identical triangels (72 peripheral, 24 central) • Evaluation was made by one doctor

  6. Repetition of aplication After the temporary improvement NV got worse Patients had shown some effect but it was still not sufficient Average number of aplications was 2,059 ± 0,8 SD (1 - 5) Minimal time period 5 weeks

  7. Results Central segments Peripheral segments The mean number of affected segments before treatment was 27,765 in the periphery of cornea and 4,294 in the central part of cornea. The mean number of affected segments after treatment was 19,471 in the periphery of cornea and 3,471 in the central part of cornea.

  8. BCVA Results

  9. BEFORE AFTER

  10. BEFORE AFTER

  11. Conclusion Our results show that the subconjunctival use of bevacizumab may represent a new and very promising method in the treatment of corneal neovascularisation. No side effect was reported by the patients. Futher prospective controled studies with larger number of patients and long term results are required.

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