Efficacy of bevacizumab in the treatment of pterygium: An updated meta-analysis of randomized controlled trials

Zhang, Xin; Jiang, Yaping; Fu, Qiang-qiang; Zhang, Xiaoyan; Chen, Yihui

doi:10.1016/j.intimp.2021.107921

Cited by 10 publications

(8 citation statements)

References 36 publications

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“…The pooled results showed that anti-VEGF drugs were not associated with more complications compared to controls, indicating their safety. It is consistent with many studies on bevacizumab ( 2 , 31 , 42 ). Subconjunctival administration especially requiring more frequent injection probably cause more side effects than topical administration.…”

Section: Discussionsupporting

confidence: 92%

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Efficacy and safety of anti-vascular endothelial growth factor agents in the treatment of primary pterygium

Zhang,

Dong,

Sun

2023

Front. Med.

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PurposeTo further evaluate the efficacy and safety of anti-vascular endothelial growth factor (VEGF) agents in management of primary pterygium.MethodsRandomized controlled trials (RCTs) in databases of PubMed, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to September 2022. Recurrences and complications were evaluated as the pooled risk ratio (RR) and 95% confidence interval (CI) using random-effects model.ResultsIn total of 1,096 eyes in 19 RCTs were included. Anti-VEGF agents statistically decreased recurrence rate of pterygium following surgery (RR 0.47, 95% CI 0.31–0.74, P < 0.001). Subgroup analysis showed that anti-VEGF as an adjunct to bare sclera (RR 0.34, 95% CI 0.13–0.90, P = 0.03) and conjunctival autograft (RR 0.50, 95% CI 0.26–0.96, P = 0.04) statistically reduced recurrence rate, while the effect was not favorable for conjunctivo-limbo autograft (RR 0.99, 95% CI 0.36–2.68, P = 0.98). Anti-VEGF agents statistically decreased recurrence in White patients (RR 0.48, 95% CI 0.28–0.83, P = 0.008), while didn't in Yellow patients (RR 0.43, 95% CI 0.12–1.47, P = 0.18). Both topical (RR 0.19, 95% CI 0.08–0.45, P < 0.001) and subconjunctival anti-VEGF agents (RR 0.64, 95% CI 0.45–0.91, P = 0.01) had a positive influence on recurrence. There was no statistically significant difference in complications between the groups (RR 0.80, 95% CI 0.52–1.22, P = 0.29).ConclusionsAs adjuvant treatment, anti-VEGF agents statistically reduced the recurrence following pterygium surgery, especially among White patients. Anti-VEGF agents were well tolerated without increased complications.

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Section: Discussionsupporting

confidence: 92%

“…This is an important reason why the current study was carried out. The most recent meta-analysis regarding the efficacy of bevacizumab on pterygium was conducted by Zhang et al ( 31 ), the study type of which was RCTs. But among the included studies, two are retrospective analysis instead of RCTs.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of anti-vascular endothelial growth factor agents in the treatment of primary pterygium

Zhang,

Dong,

Sun

2023

Front. Med.

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“…Mean sim K astigmatism was reduced after the Bevacizumab injection, which was in coherence with another study. 19 We experienced 100% improve-ment in the symptoms of grittiness, epiphora, redness, & photophobia in the majority of our patients.…”

Section: Discussionmentioning

confidence: 65%

Management of Primary Pterygium with Intralesional Bevacizumab (AVASTIN) Injection

Mahmood

Shahid²,

Awais³

et al. 2023

PAFMJ

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Objective: To determine the management of primary Pterygium with intralesional Bevacizumab (AVASTIN) Injection. Study Design: Quasi-Experimental Study Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Oct 2019 to Mar 2020. Methodology: Sixty patients of Primary Pterygium with Grades 1, 2, and 3 were included. Pre-Intralesional injection evaluation includes the Ocular surface disease Index (OSDI), grading of Pterygium and ophthalmic examination, refraction,slit lamp bimicroscopy, fundoscopy, tonometry, and corneal topography. After four weeks of intralesional injection,reassessment was done. Results: A total of 60 participants with the mean age of the participants was 44.06±14.83 years were included in the study. In 26(43.3%) patients, grittiness, epiphora, redness, and photophobia were reported, and 16(26.6%) patients reported blurring of vision that improved in 100% of patients after intralesional injections. There was statistical significance (p-value ≤0.05) in means of K1, Sim K astigmatism, Surface asymmetry index, Surface Regularity Index, Grade of Pterygium, and Ocular surface disease index before and after the intralesional injection of Bevacizumab. However, no significant difference was recorded in Uncorrected Visual Acuity, Best Corrected Visual Acuity, and K2 parameters in pre and post-injection states (p-value ≥0.05).Only 7(11.6%) patients reported subconjunctival haemorrhage after the procedure. Conclusions: Treatment of Primary Pterygium with intralesional Bevacizumab injection successfully improves symptoms,Ocular Surface Disease Index, and reduces corneal astigmatism with minimum complications.

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“…Uveal melanoma and retinoblastoma are characterized by a severe overexpression of the FGF/FGFR system, especially of the FGF-2 molecule [ 24 ]. Neoplastic (neo) angiogenesis plays a critical role in the progression of these malignancies; this mechanism is also observed in pterygia [ 25 , 26 , 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Fibroblast Growth Factor-2 (FGF-2) Expression in Pterygia Using Cell Spot Arrays

Mastronikolis

Tsiambas

Kagkelaris

et al. 2022

Vision

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Fibroblast growth factor (FGF) is a main regulator of cell differentiation, cell migration and angiogenesis in normal and abnormal conjunctiva epithelia, but specific mechanisms of its aberrant expression are yet to be investigated. In the present study, we investigated FGF-2 protein expression within several pterygia. Using a liquid-based cytology assay, we obtained cell specimens from pterygia and healthy tissues directly from patients. A combination of immunocytochemistry followed by digital image analysis showed significant overexpression of FGF-2 in all the examined pterygia. In 30/60 (50%) cases there were high levels of staining intensity, whereas in the remaining 30/60 (50%) cases there were moderate levels of expression. FGF-2 levels of the control group were significantly lower in comparison with the pterygia group. There was no significant correlation between FGF-2 levels and either sex or location of the pterygium. FGF-2 levels had a significant correlation with morphological characteristics of the pterygia. More specifically, FGF-2 levels were significantly higher in the pterygia with a fleshy morphology. Interestingly, recurrent lesions demonstrated high expression levels. An overexpression of FGF-2 has been observed frequently in pterygia, where it may play a crucial role in determining the lesion’s progression. FGF-2 upregulation correlates with the morphology of pterygia and its tendency to recur. Cell spot analysis based on liquid-based cytology is a simple, yet effective, method for detecting a broad spectrum of protein markers and could be useful in analyzing potential pterygia patient samples.

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Efficacy of bevacizumab in the treatment of pterygium: An updated meta-analysis of randomized controlled trials

Cited by 10 publications

References 36 publications

Efficacy and safety of anti-vascular endothelial growth factor agents in the treatment of primary pterygium

Efficacy and safety of anti-vascular endothelial growth factor agents in the treatment of primary pterygium

Management of Primary Pterygium with Intralesional Bevacizumab (AVASTIN) Injection

Fibroblast Growth Factor-2 (FGF-2) Expression in Pterygia Using Cell Spot Arrays

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