Subconjunctival Aflibercept for the Treatment of Formed Corneal Neovascularization

Sella, Ruti; Ishai, Meydan Ben; Livny, Eitan; Nahum, Yoav; Bahar, Irit

doi:10.1097/icl.0000000000000709

Cited by 12 publications

(11 citation statements)

References 38 publications

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“…Numerous studies on the treatment of human CNV with topical and subconjunctival VEGF inhibitors (bevacizumab, ranibizumab and aflibercept) show safety and promising therapeutic results. 15,16 In our case study, a single subconjunctival injection of 4 mg (0.1 mL) of aflibercept was sufficient for complete regression of CNV in a horse. Complications of subconjunctival injection during, immediately after the procedure and throughout the entire observation period were not observed.…”

Section: Discussionmentioning

confidence: 62%

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Successful treatment of equine corneal neovascularisation by subconjunctival aflibercept

Zadorozhnyy,

Nasinnyk,

Korol

et al. 2023

Vet Record Case Reports

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A 10‐year‐old Westphalian horse was presented for examination following a 4‐week history of ocular trauma and mycotic ulcerative keratitis of the right eye, complicated with uveitis and corneal neovascularisation. The right eye was treated for corneal neovascularisation with a 0.1 mL (4 mg) subconjunctival injection of aflibercept. A single subconjunctival injection of aflibercept was sufficient for complete regression of corneal neovascularisation. This is the first reported case of corneal neovascularisation in a horse successfully treated with subconjunctival aflibercept.

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Section: Discussionmentioning

confidence: 62%

“…Topical and subconjunctival anti‐VEGF therapy is devoid of the risks inherent in the intraocular approach. Numerous studies on the treatment of human CNV with topical and subconjunctival VEGF inhibitors (bevacizumab, ranibizumab and aflibercept) show safety and promising therapeutic results 15,16 …”

Section: Discussionmentioning

confidence: 99%

Successful treatment of equine corneal neovascularisation by subconjunctival aflibercept

Zadorozhnyy,

Nasinnyk,

Korol

et al. 2023

Vet Record Case Reports

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“…Indeed, topical and subconjunctival anti-VEGF treatment such as bevacizumab [ 7 ], ranibizumab [ 20 ] and aflibercept [ 21 , 22 ] have been extensively reported. However, corneal NV may recur [ 8 ] or persist [ 23 ] following treatment leading to repeated injections. It has been proposed that this is due to residual subclinical inflammation and rebound release of VEGF after cessation of treatment [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Initial outcomes of mitomycin intravascular chemoembolization (MICE) for corneal neovascularization

Ouano¹

2022

Int Ophthalmol

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Purpose To report on the preliminary outcomes of mitomycin C (MMC) intravascular chemoembolization (MICE) for corneal neovascularization (NV). Methods This is a retrospective case series of three consecutive eyes that underwent MICE for progressive corneal NV with sight threatening lipid keratopathy . A 1.0 cc syringe was partially filled with MMC (0.4 mg/mL) and attached to a 33-gauge needle used to cannulate the vessels. The MMC (0.01–0.05 ml) was injected with enough retrograde hydrostatic force to fill efferent and afferent vessels. Follow-up ranged from 4 months to 1 year. Results Three eyes of three patients aged 59, 73 and 33 years were included. There were no intraoperative or postoperative complications associated with the MICE procedure. Patient 1 presented with progressive corneal NV and lipid keratopathy secondary to herpes zoster ophthalmicus (HZO) and a best-corrected spectacle visual acuity (BSCVA) of 20/100 Snellen. At one-year post-MICE, there was no recurrence (BSCVA was 20/20 Snellen). Patient 2 presented with idiopathic lipid keratopathy (BSCVA 20/50 Snellen). At four months post-MICE, there were no signs of recurrence (BSCVA 20/20 Snellen). Patient 3 presented with corneal NV and lipid keratopathy secondary to HZO (BSCVA 20/30 Snellen). At four months following two MICE treatments, resolution of the lipid keratopathy was noted (BSCVA 20/20 Snellen). Conclusions Preliminary findings suggest that MICE may be an additional modality for treating progressive corneal NV with lipid keratopathy. Larger comparative studies with longer follow-up are warranted. Supplementary Information The online version contains supplementary material available at 10.1007/s10792-022-02240-6.

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“…However, partial efficacy and adverse effects, such as reduced epithelial healing and corneal thinning, have been reported [10]. Similar to steroids, the efficacy of anti-VEGF drugs in mature CoNV is still controversial [3,11,12]. Thus, alternative therapeutic approaches that are safer and more effective are needed to improve the treatment options for CoNV.…”

Section: Ivyspring International Publishermentioning

confidence: 99%

Topical application of TAK1 inhibitor encapsulated by gelatin particle alleviates corneal neovascularization

Wang¹,

Tseng²,

Lin³

et al. 2022

Theranostics

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Rationale: Corneal neovascularization (CoNV) is a severe complication of various types of corneal diseases, that leads to permanent visual impairment. Current treatments for CoNV, such as steroids or anti-vascular endothelial growth factor agents, are argued over their therapeutic efficacy and adverse effects. Here, we demonstrate that transforming growth factor-β (TGF-β)-activated kinase 1 (TAK1) plays an important role in the pathogenesis of CoNV. Methods: Angiogenic activities were assessed in ex vivo and in vitro models subjected to TAK1 inhibition by 5Z-7-oxozeaenol, a selective inhibitor of TAK1. RNA-Seq was used to examine pathways that could be potentially affected by TAK1 inhibition. A gelatin-nanoparticles-encapsulated 5Z-7-oxozeaenol was developed as the eyedrop to treat CoNV in a rodent model. Results:We showed that 5Z-7-oxozeaenol reduced angiogenic processes through impeding cell proliferation. Transcriptome analysis suggested 5Z-7-oxozeaenol principally suppresses cell cycle and DNA replication, thereby restraining cell proliferation. In addition, inhibition of TAK1 by 5Z-7-oxozeaenol blocked TNFα-mediated NFκB signalling, and its downstream genes related to angiogenesis and inflammation. 5Z-7-oxozeaenol also ameliorated pro-angiogenic activity, including endothelial migration and tube formation. Furthermore, topical administration of the gelatin-nanoparticles-encapsulated 5Z-7-oxozeaenol led to significantly greater suppression of CoNV in a mouse model compared to the free form of 5Z-7-oxozeaenol, likely due to extended retention of 5Z-7-oxozeaenol in the cornea. Conclusion:Our study shows the potential of TAK1 as a therapeutic target for pathological angiogenesis, and the gelatin nanoparticle coupled with 5Z-7-oxozeaenol as a promising new eyedrop administration model in treatment of CoNV.

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Subconjunctival Aflibercept for the Treatment of Formed Corneal Neovascularization

Cited by 12 publications

References 38 publications

Successful treatment of equine corneal neovascularisation by subconjunctival aflibercept

Successful treatment of equine corneal neovascularisation by subconjunctival aflibercept

Initial outcomes of mitomycin intravascular chemoembolization (MICE) for corneal neovascularization

Topical application of TAK1 inhibitor encapsulated by gelatin particle alleviates corneal neovascularization

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