Effect of Subconjunctival Bevacizumab on Primary Pterygium

Abstract

Treatment of primary pterygium with subconjunctival bevacizumab results in a short-term decrease in vascularization and irritation. Further long-term studies should investigate the efficacy of bevacizumab as an adjunct to surgical excision or combined topical treatment targeting other growth factors involved in pterygium pathogenesis.

Prevention of Recurrent Pterygium with Topical Bevacizumab 0.05% Eye Drops: A Randomized Controlled Trial

“…Previously, 2 different modalities of bevacizumab were investigated for the treatment of primary pterygia: subconjunctival bevacizumab alone or as an adjunctive therapy after pterygial excision. Two randomized controlled trials, 12,13 1 case series, 14 and 1 case report, 15 found that subconjunctival bevacizumab reduced the symptoms and sizes of pterygia, but the effect was temporary and not clinically relevant. [12][13][14][15] Furthermore, Razeghinejad et al 16 and Shenasi et al 17 reported that subconjunctival bevacizumab used as an adjunctive therapy after primary pterygial surgery did not significantly prevent recurrence of pterygia, even though the treatment was well tolerated.…”

Risk Factors for Recurrence After Pterygium Surgery

“…(2) Individual differences in the sensitivity to VEGF and its inhibitors may exist, which could account for the difference in the outcomes of treatment using antiangiogenic agents. [31][32][33][35][36][37] (3) Recurrence of pterygium may be induced by a multifactorial process with many confounding factors. 19 Thus, inhibition of the VEGF pathway would not be enough for the prevention of recurrence.…”

Efficacy of Intralesional Bevacizumab Administration in Primary Pterygium

“…[7][8][9] The role of anti-VEGF therapy in the treatment of primary or recurrent pterygium is evaluated in several studies. 12,15,[22][23][24][25][26] In these studies, it has been postulated that anti-VEGF therapy can inhibit limbal-conjunctival neovascularization and induce regression of the fibrovascular proliferation in the pterygium tissue. Bevacizumab is an anti-VEGF agent and has been used widely in ophthalmology practice to treat the abnormal vascular conditions of the choroid, retina, and cornea.…”

“…2,10,11 To reduce the recurrence of pterygium, various adjunctive measures like mitomycin C, beta-irradiation, and bevacizumab (Avastin; Genentech, San Francisco, CA) have been used. 2,[12][13][14][15] Bevacizumab is a recombinant humanized monoclonal antibody that binds and inhibits nonspecific VEGF. Bevacizumab has been approved by the U.S. Food and Drug Administration for the treatment of colorectal cancer.…”