Comparison of the inhibitory effect of topical cyclosporine A 0.1% and topical anti-VEGF application in an experimental model of corneal neovascularization

Ulusoy, Döndü Melek; Kahraman, Nisa; Balcıoğlu, Esra; Duru, Zeynep

doi:10.5935/0004-2749.20220004

Cited by 3 publications

(4 citation statements)

References 26 publications

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“…Topical 0.05% cyclosporine causes corneal stromal neovascularization regression and reduces the corneal graft rejection risk in selected cases. Contrastingly, topical treatment with 0.1% cyclosporine is more effective in inhibiting newly formed corneal neovascularization than bevacizumab eye drops applied to the conjunctival sac [73,74]. Cyclosporine is not a first-line treatment for corneal neovascularization.…”

Section: Immunosuppressive Drugsmentioning

confidence: 99%

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Available Therapeutic Options for Corneal Neovascularization: A Review

Drzyzga,

Śpiewak,

Dorecka

et al. 2024

IJMS

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Corneal neovascularization can impair vision and result in a poor quality of life. The pathogenesis involves a complex interplay of angiogenic factors, notably vascular endothelial growth factor (VEGF). This review provides a comprehensive overview of potential therapies for corneal neovascularization, covering tissue inhibitors of metalloproteinases (TIMPs), transforming growth factor beta (TGF-β) inhibitors, interleukin-1L receptor antagonist (IL-1 Ra), nitric oxide synthase (NOS) isoforms, galectin-3 inhibitors, retinal pigment epithelium-derived factor (PEDF), platelet-derived growth factor (PDGF) receptor inhibitors, and surgical treatments. Conventional treatments include anti-VEGF therapy and laser interventions, while emerging therapies such as immunosuppressive drugs (cyclosporine and rapamycin) have been explored. Losartan and decorin are potential antifibrotic agents that mitigate TGF-β-induced fibrosis. Ocular nanosystems are innovative drug-delivery platforms that facilitate the targeted release of therapeutic agents. Gene therapies, such as small interfering RNA and antisense oligonucleotides, are promising approaches for selectively inhibiting angiogenesis-related gene expression. Aganirsen is efficacious in reducing the corneal neovascularization area without significant adverse effects. These multifaceted approaches underscore the corneal neovascularization management complexity and highlight ideas for enhancing therapeutic outcomes. Furthermore, the importance of combination therapies and the need for further research to develop specific inhibitors while considering their therapeutic efficacy and potential adverse effects are discussed.

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Section: Immunosuppressive Drugsmentioning

confidence: 99%

“…Cyclosporine is not a first-line treatment for corneal neovascularization. Depending on the cause of the neovascularization and the patient's overall condition, other therapeutic options such as corticosteroids, anti-VEGF preparations, and surgical interventions should be considered [74,75].…”

Section: Immunosuppressive Drugsmentioning

confidence: 99%

Available Therapeutic Options for Corneal Neovascularization: A Review

Drzyzga,

Śpiewak,

Dorecka

et al. 2024

IJMS

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show abstract

“…Sonmez, Beden, and Erkan showed that topical cyclosporine 0.05% could cause regression of corneal stromal neovascularization and, in selected cases, reduce the risk of corneal graft rejection [24]. In contrast, topical treatment with cyclosporine 0.1% appears to be more effective in inhibiting newly formed corneal neovascularization than bevacizumab eye drops applied to the conjunctival sac [25]. It should be noted that using cyclosporine to treat corneal neovascularization is not a first-line treatment.…”

Section: Cyclosporin Amentioning

confidence: 99%

“…It should be noted that using cyclosporine to treat corneal neovascularization is not a first-line treatment. Depending on the cause of the neovascularization and the patient's overall condition, other therapeutic options such as corticosteroids, anti-VEGF preparations, and even surgical interventions should be considered [25,26].…”

Section: Cyclosporin Amentioning

confidence: 99%

Update on Therapeutic Approaches to Corneal Neovascularisation

Drzyzga,

Śpiewak,

Wyględowska-Promieńska

2023

Preprint

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A healthy cornea is a nonvascularized, transparent tissue. It is nourished by diffusion through the tear film, aqueous fluid and neurotrophins supplied by the corneal innervation. The cornea is devoid of both blood and lymphatic vessels, which makes it an immunologi-cally privileged tissue. Corneal neovascularization develops due to an imbalance between angiogenic and anti-angiogenic factors and can lead to a significant decrease in visual acui-ty. It may cause scarring, lipid keratopathy, and corneal edema. The resulting pathological vascularization of the cornea reduces its immune privilege and significantly worsens the prognosis after subsequent penetrating keratoplasty, increasing the risk of rejection of the transplanted flap. Neovascularization is favored by many disease processes, including auto-immune diseases, viral inflammations, mainly herpes and varicella-zoster, and blepharitis [1]. There are several options to treat corneal neovascularization, both pharmacological and surgical. Angiostatic treatment involves inhibiting the growth of new vessels by suppressing inflammatory responses. VEGF inhibitors, steroids, cyclosporine A, and amniotic membrane grafts secured to the cornea work this way. VEGF inhibitors are the agents with the direct and most potent angiostatic effect. Angioregressive treatment, on the other hand, results in the regression of already existing pathological vessels. This therapy is also based on VEGF inhibitors, which, however, have the most potent effect on newly formed and small vessels but are less effective in reducing large-caliber and mature vessels. A more effective method for such vessels is ablation, which involves surgical closure. The most commonly used an-gio-occlusive method is needle diathermy and argon or yellow laser therapy. In advanced corneal neovascularization, corneal transplant surgery may be necessary. It is best performed after pretreatment with anti-VEGF preparations, often continued after corneal transplanta-tion to reduce the risk of transplant rejection [2]. This paper discusses the pathogenesis of corneal neovascularization and the current and future trends in its treatment.

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Management of corneal neovascularization: Current and emerging therapeutic approaches

Wu,

Chan,

Lim

et al. 2024

Indian Journal of Ophthalmology

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Corneal neovascularization (CoNV) is a sight-threatening condition affecting an estimated 1.4 million people per year, and the incidence is expected to rise. It is a complication of corneal pathological diseases such as infective keratitis, chemical burn, corneal limbal stem cell deficiency, mechanical trauma, and immunological rejection after keratoplasties. CoNV occurs due to a disequilibrium in proangiogenic and antiangiogenic mediators, involving a complex system of molecular interactions. Treatment of CoNV is challenging, and no therapy thus far has been curative. Anti-inflammatory agents such as corticosteroids are the mainstay of treatment due to their accessibility and well-studied safety profile. However, they have limited effectiveness and are unable to regress more mature neovascularization. With the advent of advanced imaging modalities and an expanding understanding of its pathogenesis, contemporary treatments targeting a wide array of molecular mechanisms and surgical options are gaining traction. This review aims to summarize evidence regarding conventional and emerging therapeutic options for CoNV.

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Comparison of the inhibitory effect of topical cyclosporine A 0.1% and topical anti-VEGF application in an experimental model of corneal neovascularization

Cited by 3 publications

References 26 publications

Available Therapeutic Options for Corneal Neovascularization: A Review

Available Therapeutic Options for Corneal Neovascularization: A Review

Update on Therapeutic Approaches to Corneal Neovascularisation

Management of corneal neovascularization: Current and emerging therapeutic approaches

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