Bevacizumab (Avastin) as a potential novel adjunct in the management of pterygia

Hosseini, Hamid; Nejabat, Mahmood; Khalili, Mohammad Reza

doi:10.1016/j.mehy.2007.01.047

Cited by 44 publications

(34 citation statements)

References 18 publications

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“…Consequently, insights into the pathogenesis of pterygium were gained through the improved understanding of molecular genetic pathways (5)(6)(7)(8)(9)(10). The advent of commercially available pharmaceutical agents which could, acting on a molecular level, affect important aspects of pterygium clinical behaviour, such as the angiogenesis or cellular proliferation, opens a promising new therapeutic avenue (11,12). Therefore, future treatment options may be less invasive and more focused on molecular pathogenetic pathways.…”

Section: Introductionmentioning

confidence: 99%

Pathogenetic mechanisms and treatment options for ophthalmic pterygium: Trends and perspectives (Review)

Detorakis

Spandidos²

2009

Int J Mol Med

152

103

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Abstract. Pterygium is a fibrovascular lesion of the ocular surface that can display an aggressive clinical behavior and, occasionally, threaten vision. Although there is no consensus on its pathogenesis, recent evidence suggests that it is a proliferative, rather than degenerative condition strongly correlated with exposure to ultraviolet radiation (UVR) of solar light. Molecular genetic alterations reported in association with pterygium include loss of heterozygosity (LOH), point mutations of proto-oncogenes, such as K-ras and alterations in the expression of tumor suppressor genes, such as p53 or p63. Other findings in pterygium include the frequent detection of HPV DNA, ocular surface changes such as the overexpression of various proteins, including defensins and phospolipases D, as well as the up-regulation of growth factors, such as bFGF or VEGF. Although pterygium management has traditionally involved surgery, often enhanced by the use of antimetabolites, recent advancements in the understanding of molecular and biochemical events underlying pterygium pathogenesis may enable the use of less invasive treatment methods.

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Section: Introductionmentioning

confidence: 99%

Pathogenetic mechanisms and treatment options for ophthalmic pterygium: Trends and perspectives (Review)

Detorakis

Spandidos²

2009

Int J Mol Med

152

103

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“…Postoperative recurrence is a significant issue in pterygium management, despite sophisticated surgery or the adjunctive use of antimetabolites, such as mitomycin C (3). The use of various anti-angiogenetic factors to treat conditions associated with pathological intraocular vascular growth such as proliferative diabetic retinopathy, exudative age-related macular degeneration or neovascular glaucoma has become common (19). Such factors interfere with VEGFA and include Pegaptanib, an oligonucleotide aptamer that binds exclusively to the 165 amino-acid isoform of VEGFA, and recombinant monoclonal antibody Bevacizumab as well as its fragment Ranibizumab, both directed against VEGFA (19).…”

Section: Discussionmentioning

confidence: 99%

“…The use of various anti-angiogenetic factors to treat conditions associated with pathological intraocular vascular growth such as proliferative diabetic retinopathy, exudative age-related macular degeneration or neovascular glaucoma has become common (19). Such factors interfere with VEGFA and include Pegaptanib, an oligonucleotide aptamer that binds exclusively to the 165 amino-acid isoform of VEGFA, and recombinant monoclonal antibody Bevacizumab as well as its fragment Ranibizumab, both directed against VEGFA (19). Previous studies have evaluated the potential use of Bevacizumab in pterygium management (20,21).…”

Section: Discussionmentioning

confidence: 99%

Growth factor expression in ophthalmic pterygia and normal conjunctiva

Detorakis

Zaravinos²,

Spandidos³

2010

Int J Mol Med

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Abstract. The expression of growth factors in ophthalmic pterygium and phenotypically normal conjunctiva was examined and correlated with the clinical findings. Fifteen specimens of ophthalmic pterygia and 8 specimens of phenotypically normal conjunctiva were examined. Total RNA was extracted from all specimens and mRNA levels for transforming growth factor (TGFB1), vascular endothelial growth factor (VEGFA), basic fibroblast growth factor (FGF2), epidermal growth factor (EGF) and insulin-like growth factor (IGF1) were measured using real-time reversetranscription PCR (qRT-PCR). Differences in the expression of these factors between pterygium and conjunctival specimens were examined, as well as correlations between RNA levels and clinical parameters. mRNA levels for VEGFA and FGF2 were significantly higher in pterygium, compared with conjunctival specimens, whereas the respective differences for other factors examined were statistically not significant. The mRNA levels for VEGFA and FGF2 were also significantly higher in recurrent compared with primary pterygium. Correlations between the mRNA levels and other clinical parameters were statistically not significant for the growth factors examined. The higher levels of FGF2 or VEGFA mRNA in pterygium imply that these factors may be involved in the pathogenesis or clinical behavior of the pterygium, including postoperative recurrence. VEGFA expression may have potential for use in the selective treatment of pterygium with anti-VEGFA agents.

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“…Bevacizumab (Avastin; Genetech, San Fransisco, CA, USA) is a recombinant humanized monocolonal immunoglobulin G1 antibody that acts directly to inhibit VEGF. It was known to inhibit corneal neovascularization both in rat models and in humans [8,9]. This study was conducted to assess the additive effect of postoperative Bevacizumab eye drops to MMC augmented bare sclera in cases of primary pterygium concerning the safety and recurrence rate.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Additive Effect of Bevacizumab Eye Drops to Mitomycin C in Primary Pterygium

Fouda¹

2017

AOVS

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Purpose: To assess the additive effect of postoperative Bevacizumab eye drops to MMC augmented bare sclera in cases of primary pterygium concerning the safety and recurrence rate. Patients and methods:This prospective randomized controlled study included 20 patients with bilateral primary pterygium. The right eye of each patient was treated by simple pterygium excision with bare sclera and MMC application followed by artificial tear eye drops for 4 weeks postoperative as placebo (group I included 20 eyes) and served as the control group. The left eye of each patient was treated by simple excision with bare sclera and MMC followed by topical Bevacizumab eye drops for 4 weeks postoperative (group II included 20 eyes). Both eyes were operated upon in the same session. All subjects were examined on days 1, 7,14 and 30 and monthly for year to record any vascularization measured in mm or recurrence of pterygium measured horizontally from the limbus to its apex in the cornea.Results: After 12 months of follow up, 3 eyes (15%) with recurrence were seen in group I which was not significantly different from group II with 2 eyes (10%). No corneal neovascularization in group II except in 7 eyes of which only 1-2 mm neovessels growth in 5 eyes and one eye more than 3mm and another eye 2-3 mm however in group I no vascularization in only 5 eyes with more than 3 mm neovessels in 3 eyes, 5 eyes with neovessels 2-3 mm and 7 eyes with 1-2 mm neovessels. Total P-Value concerning the presence and absence of vascularization between the two groups was 0.000805 which was highly significant. Conclusion:Our study concluded that recurrence was not affected by the topical Bevacizumab with no statistically significant difference between the two groups; however, a statistically significant difference existed in the level of corneal neovascularization between the two groups suggesting that regression of neovessels is not a guarantee against recurrence of pterygium. Keywords Patients and MethodsThis prospective randomized controlled study included 20 patients with bilateral primary pterygium. Written consent was obtained from the patients and included an explanation of the study and agreement to have a photo of the eye area only taken. This study work follows the recommendations of the Ethics Committee of Zagazig university (ZU-IRB) which conforms to the provisions of the Declaration of Helsinki in 1995 (as revised in Edinburgh 2000). The sample size was calculated to be 40 eyes, the calculation was done using Epi-Info (Epidemiological Information Package) software version 6.1. The patients were selected from the patients attending the outpatient clinic of ophthalmology department of Zagazig University Hospital during the period from November 2013 to December 2014.To ensure matching between the study groups, patients with bilateral pterygia only were included in the study and the right eye was randomly selected to be treated with MMC only while the left eye was randomly selected to be treated with both MMC and Bevacizumab. The right ...

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Bevacizumab (Avastin) as a potential novel adjunct in the management of pterygia

Cited by 44 publications

References 18 publications

Pathogenetic mechanisms and treatment options for ophthalmic pterygium: Trends and perspectives (Review)

Pathogenetic mechanisms and treatment options for ophthalmic pterygium: Trends and perspectives (Review)

Growth factor expression in ophthalmic pterygia and normal conjunctiva

Evaluation of the Additive Effect of Bevacizumab Eye Drops to Mitomycin C in Primary Pterygium

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