Effects of subconjunctival bevacizumab on corneal neovascularization: results of a prospective study

Purpose To evaluate the effect of subconjunctival bevacizumab injections in patients with corneal neovascularization resulting from different ocular surface disorders. Methods Prospective case series. Fourteen eyes of 13 patients with corneal neovascularization caused by different ocular surface disorders, such as healed corneal ulcers, long‐standing chronic inflammatory diseases and corneal ischaemia secondary to burn were included. All eyes received a single subconjunctival injection of 2.5 mg (0.1 ml) bevacizumab. Morphological changes in neovascularization were evaluated during 3 months using slit‐lamp biomicroscopy, corneal digital photography, and computed‐assisted semi‐automatic analysis of corneal neovascularization area. Results Recession of corneal vessels was observed in all eyes at 1 week post‐injection. The surface of the neovascular tree continued to decrease noticeably for one month and then increased again for the remainder of the follow‐up period. The corneal neovascularization area amounted to 12.14± 4.38% of the corneal surface pre‐injection, compared with 9.10± 3.16% post‐injection (p=0.02), reflecting a mean decrease in corneal neovascularization of 25 %. No local or systemic adverse events possibly related to subconjunctival bevacizumab injection were observed. Conclusion Short‐term results suggest that subconjunctival bevacizumab can be used safely and effectively for corneal neovascularization resulting from different ocular surface disorders, providing an additional strategy to improve success of corneal grafts.