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Triple subconjunctival bevacizumab injection for early corneal recurrent pterygium: one-year follow-up.

ABSTRACT: The aim of the study was to evaluate the effect of 3 subconjunctival bevacizumab injections in patients with an early corneal pterygium recurrence.This study was a nonrandomized single center trial. Patients with an early corneal pterygium recurrence were selected. All patients received 3 subconjunctival bevacizumab (2.5?mg/0.1?mL) injections (basal, 2 and 4 weeks) in the recurrence area of the pterygium. The corneal and corneal-conjunctival neovascularization areas and the corneal opacification area of each pterygium were determined using digital slit lamp pictures.Thirty-eight patients were enrolled into the study; all patients were injected within 3 months of the diagnosed pterygium recurrence. Interestingly, the bevacizumab injections had a significant effect (P<0.05) on the reduction of corneal, corneal-conjunctival area of neovascularization determined as pixels and on the corneal opacification area determined as mm(2) when comparing the basal values, to the values obtained after 15 days, 1 month, 3 months, 6 months, and 12 months after injections.The vascularized area in all recurrent pterygia and the corneal opacification area with this triple regimen of subconjunctival bevacizumab injections were reduced, which remained until the end of the study. These results suggest that bevacizumab subconjunctival injections could be useful to treat recurrent pterygium.

SUBMITTER: Nava-Castaneda A

PROVIDER: S-EPMC4346374 | biostudies-literature | 2015 Mar

REPOSITORIES: biostudies-literature

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Triple subconjunctival bevacizumab injection for early corneal recurrent pterygium: one-year follow-up.

Nava-Castañeda Angel A Ulloa-Orozco Isabel I Garnica-Hayashi Lilia L Hernandez-Orgaz Joaquín J Jimenez-Martinez Maria Carmen MC Garfias Yonathan Y

Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics 20141104 2

<h4>Purpose</h4>The aim of the study was to evaluate the effect of 3 subconjunctival bevacizumab injections in patients with an early corneal pterygium recurrence.<h4>Methods</h4>This study was a nonrandomized single center trial. Patients with an early corneal pterygium recurrence were selected. All patients received 3 subconjunctival bevacizumab (2.5 mg/0.1 mL) injections (basal, 2 and 4 weeks) in the recurrence area of the pterygium. The corneal and corneal-conjunctival neovascularization are ...[more]

PMID: 25369364

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Project description:PurposeTo assess the efficacy and safety of a single preoperative intralesional bevacizumab injection as an adjuvant treatment before primary pterygium surgery.MethodsWe conducted a randomized controlled interventional study from January 2019 to December 2020. The study included a total of 60 patients (60 eyes) with primary pterygium. We defined two groups of 30 patients each. Group A received an intralesional injection of bevacizumab (Avastin), 1 month before surgery (lesion excision and conjunctival autograft). Group B (control) had only the surgical treatment. Patients were followed up 7 days (D7), 1 month (M1), 3 months (M3), and 6 months (M6) postoperatively. Pre-, per-, and postoperatively, photographs of the lesions were taken, as well as a histopathological examination. The main outcome measures were the change in functional discomfort following intralesional bevacizumab injection and pterygium recurrence. Recurrence was defined as fibrovascular tissue growth invading the cornea. Therapeutic success was defined as the absence of pterygium recurrence in M6.ResultsThe mean age of the 60 patients was 54.17 ± 10.53. After bevacizumab injection, the preoperative functional discomfort score decreased significantly (P = 0.048). There was a significant improvement in grade and color intensity (P = 0.001). We noted no local nor systemic complications after intralesional injection of bevacizumab. After pterygium excision, the success rate was statistically higher in Group A (P = 0.047). There was no significant difference in either final best-corrected spectral visual acuity or astigmatism between the two groups. We noted a statistically significant association between recurrence and color intensity (P = 0.046), vascular density (P = 0.049), and the degree of elastic tissue degeneration (P = 0.040).ConclusionA single preoperative subconjunctival injection of bevacizumab 1 month before surgery decreases the vascularity of newly formed blood vessels and hence may reduce the recurrence rate.

Project description:Mesenchymal stem cells (MSCs) have unique and beneficial properties and are currently used to treat a broad variety of diseases. These properties include the potential for differentiation into other cell types, secretion of different trophic factors that promote a regenerative microenvironment, anti-inflammatory actions, selective migration to damaged tissues, and non-immunogenicity. MSCs are effective for the treatment of ocular surface diseases such as dry eye, corneal burns, and limbal stem cell deficiency (LSCD), both in experimental models and in humans. LSCD is a pathological condition in which damage occurs to the limbal epithelial stem cells, or their niche, that are responsible for the continuous regeneration of the corneal epithelium. If LSCD is extensive and/or severe, it usually causes corneal epithelial defects, ulceration, and conjunctival overgrowth of the cornea. These changes can result in neovascularization and corneal opacity, severe inflammation, pain, and visual loss. The effectiveness of MSCs to reduce corneal opacity, neovascularization, and inflammation has been widely studied in different experimental models of LSCD and in some clinical trials; however, the methodological disparity used in the different studies makes it hard to compare outcomes among them. In this regard, the MSC route of administration used to treat LSCD and other ocular surface diseases is an important factor. It should be efficient, minimally invasive, and safe. So far, intravenous and intraperitoneal injections, topical administration, and MSC transplantation using carrier substrata like amniotic membrane (AM), fibrin, or synthetic biopolymers have been the most commonly used administration routes in experimental models. However, systemic administration carries the risk of potential side effects and transplantation requires surgical procedures that could complicate the process. Alternatively, subconjunctival injection is a minimally invasive and straightforward technique frequently used in ophthalmology. It enables performance of local treatments using high cell doses. In this review, we provide an overview of the current status of MSC administration by subconjunctival injection, analyzing the convenience, safety, and efficacy for treatment of corneal failure due to LSCD in different experimental models. We also provide a summary of the clinical trials that have been completed, are in progress, or being planned.

Dataset Information

Triple subconjunctival bevacizumab injection for early corneal recurrent pterygium: one-year follow-up.

Publications

Triple subconjunctival bevacizumab injection for early corneal recurrent pterygium: one-year follow-up.

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