Short-term topical bevacizumab in the treatment of stable corneal neovascularization

Purpose: To evaluate the safety and efficacy of topical bevacizumab in the treatment of corneal neovascularization. Design: Prospective, nonrandomized, interventional case series. Methods: setting: Institutional, multicenter clinical trial. study population: Twenty eyes from 20 patients with stable corneal neovascularization. intervention procedures: Patients were treated with topical 1.0% bevacizumab for 3 weeks and were monitored for a total of 24 weeks. main outcome measures: Primary outcome measures included: neovascular area, defined as the area of the corneal vessels themselves; vessel caliber, defined as the mean corneal vessel diameter; and invasion area, defined as the fraction of the total cornea into which the vessels extended. The occurrence of ocular and systemic adverse events was monitored closely. Results: As compared with the baseline visit, patients exhibited a statistically significant improvement in neovascular area by week 6 (P =.007) and in vessel caliber by week 12 (P =.006). At the final visit, neovascular area, vessel caliber, and invasion area were reduced by 47.5%, 36.2%, and 20%, respectively. The decreases in neovascular area and vessel caliber were statistically significant (P <.001 and P =.003, respectively); however, the reduction in invasion area did not reach statistical significance (P =.06). There were no significant changes in the secondary outcomes, and there were no adverse events. Conclusions: Short-term topical bevacizumab treatment reduced the extent of stable corneal neovascularization as measured by neovascular area and vessel caliber with no associated adverse events. Interestingly, the degree of treatment efficacy was inversely proportional to the baseline invasion area.