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Results of a Prospective, Open-Label, Noncomparative Study

Mohammad H. Dastjerdi, MD; Khalid M. Al-Arfaj, MD; Nambi Nallasamy, BA; Pedram Hamrah, MD; Ula V. Jurkunas, MD; Roberto Pineda II, MD; Deborah Pavan-Langston, MD; Reza Dana, MD, MSc, MPH

Arch Ophthalmol. 2009;127(4):381-389.

Objective  To study the safety and efficacy of topical bevacizumab in the treatment of corneal neovascularization (NV).

Design  In a prospective, open-label, noncomparative study, 10 eyes from 10 patients with stable corneal NV were treated with topical bevacizumab, 1.0%, for 3 weeks and followed up for up to 24 weeks.

Main Outcome Measures  The primary safety variables were the occurrence of ocular and systemic adverse events throughout the course of the study. The primary efficacy variables were neovascular area, the area of the corneal vessels themselves; vessel caliber, the mean diameter of the corneal vessels; and invasion area, the fraction of the total corneal area covered by the vessels.

Results  From baseline visit to the last follow-up visit, mean reductions were 47.1% (standard deviation [SD], 36.7%) for neovascular area, 54.1% (SD, 28.1%) for vessel caliber, and 12.2% (SD, 42.0%) for invasion area. The decreases in neovascular area and vessel caliber were statistically significant (P = .001 and P < .001, respectively). However, changes in invasion area did not achieve statistical significance (P = .19). Visual acuity and central corneal thickness showed no significant changes. Topical bevacizumab was well tolerated with no adverse events.

Conclusions  Short-term topical bevacizumab therapy reduces the severity of corneal NV without local or systemic adverse effects.

Application to Clinical Practice  Topical bevacizumab provides an alternative therapy in the treatment of stable corneal NV.

Trial Registration  clinicaltrials.gov Identifier: NCT00559936

Author Affiliations: Cornea and Refractive Surgery Service, Massachusetts Eye and Ear Infirmary, Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.

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