Delayed corneal epithelial healing after intravitreal bevacizumab: A clinical and experimental study

Gustavo A. Colombres, Ana L. Gramajo, Maria P. Arrambide, Silvina M. Juarez, J. Fernando Arevalo, Jorge Bar, Claudio P. Juarez, Jose D. Luna

Research output: Contribution to journalArticle

Abstract

Purpose: To report corneal epithelial defects (CEDs) and delayed epithelial healing after intravitreal bevacizumab (IVB) injection and to describe delayed corneal epithelial healing with topical administration of bevacizumab in an experimental rabbit model. Methods: A retrospective chart review was performed on 850 eyes of 850 patients with neovascular eye disease and diabetic macular edema who had received 1.25 to 2.5 mg IVB. In the experimental arm of the study, photorefractive keratectomy was used to create a 3 mm CED in the right eyes of 18 New Zealand rabbits which were then randomized to three equal groups. All rabbits received topical antibiotics, additionally those in group A received topical bevacizumab and animals in group B were treated with topical corticosteroids. The rate of epithelial healing was assessed at different time points using slitlamp photography. Results: In the clinical study, seven eyes of seven subjects developed CEDs the day after IVB injection. All of these eyes had preexisting corneal edema. The healing period ranged from 3 to 38 days (average 11 days) despite appropriate medical management. In the experimental study, topical bevacizumab and corticosteroids both significantly hindered corneal epithelial healing at 12 and 24 hours. Conclusion: Bevacizumab was demonstrated to cause CEDs in clinical settings. Moreover, corneal epithelial healing was delayed by topical application of bevacizumab, in the experimental model. These short-term results suggest that corneal edema may be considered as a risk factor for epithelial defects after IVB.

Original languageEnglish (US)
Pages (from-to)18-25
Number of pages8
JournalJournal of Ophthalmic and Vision Research
Volume6
Issue number1
StatePublished - Jan 1 2011

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Keywords

  • Antiangiogenics
  • Complications
  • Corneal edema
  • Corneal epithelial defect
  • Intravitreal bevacizumab

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Colombres, G. A., Gramajo, A. L., Arrambide, M. P., Juarez, S. M., Fernando Arevalo, J., Bar, J., Juarez, C. P., & Luna, J. D. (2011). Delayed corneal epithelial healing after intravitreal bevacizumab: A clinical and experimental study. Journal of Ophthalmic and Vision Research, 6(1), 18-25.