Antivascular endothelial growth factor in the approach to infectious keratitis



Session Details

Session Title: Cornea: Medical

Session Date/Time: Tuesday 10/10/2017 | 08:00-10:30

Paper Time: 08:30

Venue: Room 3.6

First Author: : T.Torrent SPAIN

Co Author(s): :    F. March de Ribot   J. Tarrus Bozal                 

Abstract Details

Purpose:

The cornea possesses an inherent immune privilege, and inflammation is self-regulated so as to preserve the functions and transparency. The cornea is avascular due to active mechanisms inhibiting the angiogenesis, corneal neovascularization occurs when there are more angiogenic than antiangiogenic factors. Vascular endothelial growth factor (VEGF) is one of the most important angiogenesis molecules. Anti-VEGF agents have efficacy in the treatment of neovascular age-related macular degeneration, diabetic retinopathy, macular oedema, neovascular glaucoma, and other neovascular diseases. These same agents have great potential for the treatment of corneal neovascularization.

Setting:

Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain.

Methods:

Case series. We present 10 clinical cases that were treated with intrastromal injections of Bevacizumab as an adjuvant treatment for keratoplasty or as a single treatment. 6 had previously Herpes Simplex Virus (HSV) keratitis, 3 bacterial keratitis (Klebsiella, Staphylococcus Aureus and Streptococcus Pneumoniae), 1 patient with Acanthamoeba. All patients were treated with intraestromal injections of Bevacizumab after the acute infectious phase was overcome

Results:

After a mean follow-up of one year, a mean of 3 injections per patient was needed. 3 patients received a subsequent keratoplasty with success, 4 patients improved vision only with anti-VEGF since the corneal oedema diminished after reducing leakage of new vessels, 3 patients are still on treatment.

Conclusions:

Corneal neovascularization is a serious condition that can lead to a profound decline in vision. Abnormal vessels block light, cause corneal scarring, compromise visual acuity, and may lead to inflammation and oedema. In corneal transplantation they can lead to corneal rejection. Infectious diseases and a vascular response to corneal transplantation are major causes of corneal neovascularization. Antiangiogenic therapy demonstrates great promise for future treatment of this condition.

Financial Disclosure:

NONE