Topical Bevacizumab and Ocular Surface Neovascularization in Patients With Stevens-Johnson Syndrome

Uy, Harvey S.; Chan, Pik Sha; Ang, Robert Edward

doi:10.1097/ico.0b013e318158f6ad

Cited by 73 publications

(39 citation statements)

References 32 publications

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“…Most reports on humans evaluated concentrations of bevacizumab ranging from 1 to 12.5 mg/ml [3,5,6,7], and there are only a few case reports in the literature describing the application of higher concentrations (i.e. 25 mg/ml) for this use [8,9,10]. The aim of the current study was to evaluate the efficacy and safety of high-dose topical bevacizumab administered over a period of 2 weeks to a group of patients with corneal neovascularization resulting from different etiologies.…”

Section: Introductionmentioning

confidence: 99%

High-Dose Topical Bevacizumab for Corneal Neovascularization

et al. 2013

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Background/Aims: Bevacizumab (Avastin), an anti-vascular endothelial growth factor drug, has been successfully used in the recent years to treat ocular pathologies, mostly by intravitreal administration. The aim of the current study was to assess the off-label topical use of high-dose bevacizumab for the treatment of corneal neovascularization. Methods: Seventeen eyes of 17 patients with corneal neovascularization secondary to various pathologies were included. The patients were treated with topical bevacizumab (25 mg/ml) 4 times daily for 2 weeks. The following parameters were evaluated at baseline and on days 3, 7 and 14: visual acuity, slit-lamp examination, intraocular pressure, heart rate and blood pressure. Color photos were obtained at baseline and on day 14. Results: Eleven eyes (65%) demonstrated regression of corneal neovascularization and/or clearing of corneal opacification. Adverse ocular events were mild and transient, and included eyelid swelling/chalazion and superficial punctate keratitis. Conclusion: Treatment with high-dose topical bevacizumab (25 mg/ml) was effective for corneal neovascularization in nearly two thirds of the eyes treated. Adverse ocular side effects were mild and transient.

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Section: Introductionmentioning

confidence: 99%

High-Dose Topical Bevacizumab for Corneal Neovascularization

et al. 2013

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“…Hosseini and Khalili have shown its usefulness in inhibiting the neovascularisation in herpetic stromal keratitis [47]. Successful off-label use of topical bevacizumab has been studied in patients with pterygium and in patients with Steven Johnson's syndrome [48][49][50].…”

Section: Discussionmentioning

confidence: 99%

Post-trabeculectomy topical bevacizumab preventing bleb failure: a preliminary study

Bhasker

Saxena

Singh

2012

j ocul biol dis inform

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This study aims to evaluate the efficacy and safety of post-trabeculectomy topical bevacizumab, in preventing bleb failure. A total of 11 females and 12 males were enrolled for the study. After a complete ophthalmic evaluation, the patients underwent trabeculectomy. Full ophthalmic examination was done the next day, which included visual acuity, intraocular pressure (IOP), and bleb morphology. Next, two drops of bevacizumab [0.25 mg (0.01 ml)] were instilled over the wound area with a tuberculin (1 ml) syringe. Pressure was applied at the medial canthus to prevent it from going into the lacrimal passage. Similar postoperative procedures were repeated at 1, 2, 3, and 4 weeks. So in all, five instillations of bevacizumab were completed. Later, the patients were followed at 1-month interval for 6 months. Target IOP was achieved in all eyes and was maintained during the study period of 6 months without any anti-glaucoma medication. Average IOP before trabeculectomy was 27.27±8.92 mmHg, which decreased postoperatively to 8.77±0.97 mmHg at 3 months and 9.27±1.16 mmHg at 6 months. This drop in IOP was statistically significant on both occasions (p=0.00). A nice low filtering bleb was formed after the surgery, and it remained the same during the study period. The other parameters like cup-to-disc ratio and visual field did not change during the 6 months of study as expected because glaucoma is a slow progressive disease. Modulating the wound at multiple sites by bevacizumab (inflammation, proliferative, and remodeling stages) can lead to success of trabeculectomy.

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“…No serious adverse events were reported. 4,5 In another small masked study involving 10 subjects with corneal vascularisation who received bevacizumab injections, a 29 per cent decrease in vascularisation was observed. 6 Further larger studies are needed to fully evaluate the long-term effects of this novel treatment.…”

Section: Avastin Treatment For Corneal Neovascularisationmentioning

confidence: 99%

Ocular therapeutics

Albietz¹,

Napper²

2008

Clinical and Experimental Optometry

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Adherence in glaucomaCorrect use of medications has always been a problem, especially in chronic diseases. A new study using electronic monitoring of drug-bottle opening as an objective measurement of adherence in medical glaucoma management has confirmed the already widely accepted clinical impression that more complex glaucoma topical medication dosing regimens result in poorer adherence. Previously the term 'compliance' was used but 'adherence' is now considered a more appropriate term. Two populations of primary open angle glaucoma subjects were examined: those using monotherapy (once-daily prostaglandin analogues n = 31) and those requiring an adjunctive medicine to the prostaglandin analogue (two-drug group n = 31). The main outcome measures were dosing errors (number of underadherence or over-adherence events) and coverage (proportion of pharmacologic duration covered by dosing) relative to the prescribed regimen. Adherence to the prostaglandin once daily was good in both groups by all measures (less than 10 per cent of subjects with more than five dosing errors and mean coverage of 97.2 Ϯ 6.1 per cent). Adherence to the second medication in the two-drug group was poorer (37 per cent of subjects with more than five dosing errors and mean coverage of 85.6 Ϯ 12.6 per cent). For the subjects using beta-blockers, 24.8 Ϯ 18.4 per cent of doses were taken at less than 10-hour intervals (over-adherence).Robin AL, Novack GD, Covert DW, Crockett RS, Marcic TS. Adherence in glaucoma: Objective measurements of once-daily and adjunctive medication use. Am J Ophthalmol 2007; 144: 533-540. Topical insulin improves corneal healing in diabetesCorneal epithelial healing can be a significant problem among diabetic patients. A recent study using a rat model with diabetes mellitus has shown that topical application of insulin normalised delayed corneal wound healing. The method involved creating a five-millimetre corneal abrasion, which was treated topically for seven days (four times daily) with 1, 2, or 5 U of insulin or with sterile vehicle.After seven days, residual corneal epithelial defects of rats with diabetes receiving the sterile vehicle were approximately 35 per cent larger than in healthy (nondiabetic) rats receiving the sterile vehicle. Diabetic rats receiving topical insulin had wounds ranging from 19 to 60 per cent smaller than diabetic rats not receiving topical insulin, similar to wound sizes in healthy rats. Topical insulin had no effect on re-epithelialisation of corneal wounds in healthy rats, corneal thickness, intraocular pressure or serum glucose level. The corneal sensitivity of diabetic rats was markedly reduced from healthy rats but rats with diabetes given insulin had corneal sensitivity values comparable to the healthy rats. DNA synthesis in the corneal epithelium was decreased in rats with diabetes but was comparable to that in healthy rats after they received topical insulin. Apoptosis and necrosis levels were similar in all healthy rats, diabetic rats treated with insulin and untreated diabetic...

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Topical Bevacizumab and Ocular Surface Neovascularization in Patients With Stevens-Johnson Syndrome

Cited by 73 publications

References 32 publications

High-Dose Topical Bevacizumab for Corneal Neovascularization

High-Dose Topical Bevacizumab for Corneal Neovascularization

Post-trabeculectomy topical bevacizumab preventing bleb failure: a preliminary study

Ocular therapeutics

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