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Aims: To evaluate and compare the inhibitory effects of topical and subconjunctival bevacizumab on corneal neovascularization in a rat model. Methods: Twenty corneas of 20 rats were chemically cauterized with silver nitrate sticks. Animals were randomized into four groups: a control group that received only topical artificial tear drops twice daily, a subconjunctival injection group that received 1.25 mg (0.05 ml) of bevacizumab on the 1st, 4th, and 7th day, and two topical bevacizumab groups that received instillation of 4 or 12.5 mg/ml bevacizumab twice daily. Digital photographs of the cornea were taken and analyzed using an image analysis software program. On the 10th day, corneas were excised and examined histologically. Results: The mean percentage of the vascularized corneal area (%) in the control group was 63.32 ± 13.10 (mean ± SD), compared with 30.22 ± 15.73 in the subconjunctival injection group, 26.76 ± 10.23 in the 4-mg/ml topical group, and 25.52 ± 12.45 in the 12.5-mg/ml group. The differences between the control and each treatment group were significant (all p < 0.01). Further, histological examination revealed that each treatment group had fewer vessels than the control group (all p < 0.01). Conclusions: Both subconjunctival injection and topical use of bevacizumab are effective and safe in controlling corneal neovascularization. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

. Purpose: To evaluate the effect of different bevacizumab concentrations on retinal endothelial cell proliferation, retinal structures and apoptotic activity after intravitreal injection in a retinopathy of prematurity (ROP) mouse model. Methods: A total of 35 of C57BL/J6 mice were exposed to 75 ± 2% oxygen from postnatal day 7 to postnatal day 12. On day 12, 10 mice (group C) were injected with 2.5 μg intravitreal bevacizumab (IVB), 11 mice (group D) were injected with 1.25 μg IVB, and 14 mice (group E) were injected with 0.625 μg IVB in one eye. The contralateral eyes were injected with isotonic saline (control group = group B). Four nonexposed mice served as negative controls (group A). Neovascularization was quantified by counting the endothelial cell proliferation on the vitreal side of the inner limiting membrane of the retina. Histological and ultrastructural changes were examined by light and electron microscopy. Terminal deoxynucleotidyl transferase deoxy-UTP-nick end labelling (TUNEL) was used to detect apoptosis. Results: The endothelial cell count per histological section was lower in groups C (p < 0.0001), D (p < 0.0001) and E (p < 0.0001) compared with the control group B. Histological evaluation showed no retinal toxicity in any group. Electron microscopy revealed hyperoxia-induced mitochondrial dysmorphology in group B. Mitochondrial dysmorphology displayed dose-dependent gradual increase in IVB-injected eyes. Intravitreal bevacizumab induced no significant increase in apoptotic cell death. Conclusion: Bevacizumab suppresses endothelial cell proliferation in a ROP mouse model. In addition to hyperoxia-induced mitochondrial dysmorphology of C57BL/J6 retina, morphological findings implicate further mitochondrial vulnerability because of bevacizumab without increase in apoptotic cell death. [ABSTRACT FROM AUTHOR]

Purpose: To report a series of severe corneal changes following intravitreal injection of bevacizumab (Avastin) for age-related macular degeneration. Design: Retrospective noncomparative case series. Methods: The authors retrospectively reviewed the corneal changes that developed after the procedure in 1200 (460 patients) intravitreal injections of bevacizumab. Results: Five significant corneal changes (1.1%) occurred in these patients within the 1st postinjection week. The severe corneal changes included corneal infiltrative keratitis ( n = 2) and corneal stromal edema and descemet folds ( n = 3). The findings depended on clinical examination and biomicroscopic and confocal evaluation. In terms of causality assessment, no rechallenge was possible. The appropriate treatment was applied and recovery was achieved in all patients during the follow-up period. Conclusions: Intravitreal injection of bevacizumab may cause corneal changes. The safety and effects of bevacizumab on the cornea should be evaluated in detail. [ABSTRACT FROM AUTHOR]

Punctate inner choroidopathy is an idiopathic, inflammatory disorder that is characterized by yellowish white spots at the level of retina pigment epithelium and inner choroid. It is associated with a high incidence of choroidal neovascularization (CNV). Vision loss occurs mainly due to CNV development, and treatment options include systemic steroids, laser photocoagulation, interferon ?1a, and submacular surgery. We report a case of punctate inner choroidopathy and discuss the results of intravitreal bevacizumab treatment for CNV. [ABSTRACT FROM AUTHOR]

Purpose: To present the treatment approach to ocular complications in two cases with autosomal recessive dystrophic epidermolysis bullosa (EB) and to review the literature. Material and Method: Two teenage girls with EB, one with symblepharon (case 1) and the other with corneal opacity and vascularization (case 2) presented to our clinic. Case 1 had symblepharon, extending from the left upper eyelid to the superotemporal cornea, restricting the globe movements. During surgery, symblepharon lysis and lamellar keratectomy were followed by amniotic membrane transplantation to cover the cornea and palpebral conjunctiva. At presentation, case 2 was using artificial tears and topical cyclosporin A. The right eye had visual acuity of counting fingers, and opacity with superficial and deep vascularization in the lower third of the cornea. Topical bevacizumab and autologous serum were added to her treatment. Results: In Case 1, 63 months after surgery the eyelid margin was smooth and the eye was fully mobile. A mild symblepharon of the temporal conjunctiva in both eyes was present. Stromal thinning, superficial vascularization and opacification were significant in the temporal cornea. During the 8-month follow-up period of case 2, the visual acuity increased to 20/50. Slit-lamp examination showed a decrease in corneal opacity and vascularization. Discussion: According to our cases, alternative treatments such as amniotic membrane transplantation to treat symblepharon, and topical bevacizumab and autologous serum in intractable vascularization and opacity can be considered in cases of EB. [ABSTRACT FROM AUTHOR]

Purpose: To report a case of presumed Eales disease that showed regression of retinal neovascularization after the use of intravitreal bevacizumab. Design: Retrospective, interventional case report. Methods: Broad retinal neovascularization in a patient with presumed Eales disease did not regressed despite adequate photocoagulation treatment, and bevacizumab (1.25 mg) was injected intravitreally. The patient was followed up for 1 year. Results: One week after injection, fluorescein angiography demonstrated dramatic regression of retinal neovascularization. After 12-months, visual acuity was improved and no signs of recurrence were observed. Conclusion: Intravitreal bevacizumab may be effective as an adjunctive treatment of retinal neovascularization in patients with Eales disease. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses the study on the impact of topical bevacizumab as an adjunctive therapy for neovascularization of cornea.

Purpose: To determine the long-term efficacy and reliability of intravitreal bevacizumab injection in neovascular glaucoma. Materials and Methods: Eighteen eyes of twelve patients (8 men, 4 women) with diagnosis of neovascular glaucoma were included in this study group. Twelve eyes had proliferative diabetic retinopathy (66.7%) and 6 eyes (33.3%) had central retinal vein occlusion. Intravitreal bevacizumab (1.25 mg/0.05 ml, Altuzan) was injected in all eyes after the completion of laser therapy. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured before and at 1st week, 1st month, 3rd month, and 6th month after the injection; and anterior segment angiography images were obtained before and at the 1st week, 3rd month and 6th month after the injection. Angiographic images were evaluated according to the grading system of iris neovascularization (Stage 0-4). Results: The decrease of symptoms and regression in grade of neovascularization were determined at the first week in all eyes. The mean IOP values were 26.32±1.37 mmHg, 24.14±2.03 mmHg, 26.78±2.19 mmHg, and 27.72±2.28 mmHg at the 1st week, 1st month, 3rd month, and 6th month after injection, respectively (p<0.05). The mean BCVA was 1.14±0.21 LogMAR (0.7-2.0) at the 6th month, and there was no significant difference from preinjection values (p>0.05). Discussion: Intravitreal injection of bevacizumab seems to be effective and safe treatment modality for neovascular glaucoma in long-term period and it can be used as an adjuvant therapy to the panretinal photocoagulation and antiglaucomatous agents. [ABSTRACT FROM AUTHOR]