Posters

Corneal stromal dissection after intrastromal injection of bevacizumab in metaherpetic corneal neovascularization

Poster Details

First Author: C. Sanz-Pozo SPAIN

Co Author(s):    J. Peraza-Nieves   P. Cifuentes-Canorea   M. Sastre-Ibanez   N. Avalos-Franco   G. Arcos-Villegas   R. Mendez-Fernandez     

Abstract Details

Purpose:

To describe a potential complication during intrastromal injection of Bevacizumab in a patient with lipoid deposition secondary to corneal neovascularization.

Setting:

Hospital Clínico San Carlos de Madrid. Tertiary referal center.

Methods:

A 44 years old male came to the emergency room complaining of 'white spot' on right eye (OR) and blurred vision without pain during last year. The patient had previous history of herpetic keratitis. Best corrected visual acuity (BCVA) was 0.8 in OR. Biomicroscopy showed a superior paracentral mid-stromal opacification in OR with deep stromal lipid deposition secondary neovascularization superiorly. Intrastromal and yuxtalimbal subconjunctival injections of Bevacizumab 1.25 mg/0.05 mL were indicated. While performing the injection an up-to-down lamellar dissection was produced. A 50 % air bubble anterior chamber fulfill was left.

Results:

At First day postoperative control, BCVA was 0.4 which improved to 0.7 with pinhole. Intraocular pressure was normal. Biomicroscopy showed traces of blood at deep stromal lamellar interface. Anterior segment optical coherence tomography ( AS-OCT) showed a 344 microns deep lamellar dissection with a posterior lamella of 100 microns separated by a 128 microns pocket. The patient was treated with tobramycin/dexamethasone 3mg/ml-1mg/ml twice a day. 3 weeks later, the BCVA remained stable and we noticed decrease of the opacity, lipoid deposition and absence of corneal neovascularization. AS-OCT confirmed complete resolution of corneal lamellar dissection.

Conclusions:

A deep stromal lamellar dissection can occur after injecting a small volume of Bevacizumab with complete spontaneous resolution. Bevacizumab may be a good option for treating lipoid deposits and corneal neovascularization as metaherpetic sequelae.

Financial Disclosure:

NONE