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
Subconjunctival injection of bevacizumab (0,75 mg - 0,03 ml)
Usually 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 Peripheral segments Central 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.