• Fri. Nov 15th, 2024

Huang AJ, Watson BD, Hernandez E, Tseng SC

Byacusticavisual

Oct 30, 2024

Huang AJ, Watson BD, Hernandez E, Tseng SC. corneal region covered by the vessels. Results From baseline visit to the last follow-up visit, the mean reduction was 47.1% 36.7% for NA, 54.1% 28.1 for VC, and 12.2% 42.0% for IA. The decreases in NA and VC were statistically significant (p = 0.0014 and p = 0.00009, respectively). However, changes in IA did not achieve statistical Moxisylyte hydrochloride significance (p = 0.19). Visual acuity and central corneal thickness showed no significant changes. Topical bevacizumab was well-tolerated with no adverse events. Conclusions Short-term topical bevacizumab therapy reduces the severity of corneal NV without local or systemic side-effects. Moxisylyte hydrochloride Application to Clinical Practice Topical bevacizumab provides an alternative therapy in the treatment of stable corneal neovascularization. Trial Registration clinicaltrials.gov Identifier: NCT00559936 The cornea has the unique feature (except for cartilage) of being normally avascular, but under pathologic conditions vessels invade the cornea from the limbal vascular plexus. A wide variety of insults including infection, inflammation, ischemia, degeneration, trauma, and loss of the limbal stem cell barrier can cause corneal neovascularization (NV).1 Although corneal NV can occasionally serve a beneficial role in the clearing of infections, wound healing, and in arresting stromal melts,2 its disadvantages are numerous. Corneal NV often leads to tissue scarring, edema, lipid deposition, and persistent inflammation that may significantly alter visual acuity. 3 Based on data derived from the Massachusetts Eye and Ear Infirmary in 1996, it is estimated that for any given year, 1.4 million patients in the US develop corneal NV, among whom 12% of cases are associated with a decrease in visual acuity.4 Twenty percent of corneal specimens obtained during corneal transplantation show histopathologic evidence of NV.5 Corneal NV accompanies the most common causes of corneal infectious blindness in both the developed (herpetic keratitis)6 and developing (trachoma and onchocerciasis) world,7 which cause millions to lose their sight. Corneal NV is also notable in extended-wear usage of hydrogel contact lenses.8, 9 The prevalence of neovascularization ranges from 125,000 to 470,000 people in the US who wear soft lenses for refractive correction.4 All these data indicate that corneal NV is a significant contributor to eye disease. Corneal NV may not only reduce visual acuity but also it results in the loss of the immune privilege of the cornea, thereby worsening the prognosis of subsequent penetrating keratoplasty (PK).10 Preexisting corneal stromal blood vessels have been identified as strong risk factors for immune rejection after corneal transplantation.11, 12 For instance, whereas the success rate of corneal transplantation in low-risk avascular beds surpasses 90%, the survival rates are drastically lower in high-risk neovascularized beds in which corneal grafts suffer from rejection rates far worse than first kidney or heart allografts.11, 12 Current treatments for corneal NV including medications, such as steroids or non-steroidal anti-inflammatory agents, laser photocoagulation, fine-needle diathermy, photodynamic therapy, or restoration of the ocular surface with the use of conjunctival, limbal, or amniotic membrane transplantation have demonstrated variable and largely limited clinical success.1 The highly variable efficacy and myriad side-effects (cataract, glaucoma, and increased risk of infection) of topical and Rabbit polyclonal to PDCD6 systemic corticosteroids are well known to clinicians who use these agents regularly in trying to arrest these disease processes. Other treatment modalities are often ineffective, or vessel recanalization occurs requiring multiple treatment sessions which can lead to serious side effects. Furthermore, none of Moxisylyte hydrochloride these treatments specifically target the molecular mediators of angiogenesis.13 Vascular endothelial growth factor (VEGF) is thought to be a key mediator in the process of neovascularization.13 The prominent role of VEGF in the pathophysiology of corneal NV has been demonstrated in experimental models of corneal NV.14 It has been shown that VEGF is up-regulated in inflamed and vascularized corneas in humans and in animal models.15 It has also been shown that inhibition of angiogenesis by neutralization of VEGF can Moxisylyte hydrochloride promote corneal graft survival in animal models.16 VEGF inhibitors such as pegaptanib sodium (Macugen; [OSI] Eyetech/Pfizer, Inc, New York, NY), ranibizumab (Lucentis; Genentech Inc., San Francisco, CA) and bevacizumab (Avastin; Genentech Inc., San Francisco,.