Efficacy and safety of subconjunctival bevacizumab for recurrent pterygium

Abstract

Purpose: To evaluate the clinical outcome(s) and complication(s) of subcon junctival bevacizumab treatment in patients with recurrent pterygium. Methods: This prospective case series included patients who had undergone pterygium surgery and were diagnosed with recurrent pterygium. All patients received one subconjunctival injection of 0.5 mL of bevacizumab (2.5 mg/0.1 mL). The main outcome was the change in size and clinical appearance. The clinical appearance of the pterygium was graded according to Tan and colleagues. The horizontal size of the pterygium (from limbus to apex) was recorded from baseline to 2 months after injection. Treatmentrelated complications and adverse events were reported. Results: We included 36 eyes of 36 patients (18 males) with a mean age of 58.75 ± 10.98 years. Totally, 30.6% patients developed recurrent pterygium in both eyes (only the worst eye was treated), with 47.2% developing it in the left eye and 22.2% in the right eye. More than half the patients (58.3%) had a family history of pterygium. There was a significant difference in the size of pterygium at different intervals (P<0.05). Approximately twothirds (66.7%) of patients pre sented with hyposphagma on the 2 nd day after subconjunctival application; this value decreased to 30.6% by day 7 and to 0% at 1 month. Most patients (69.4%) ex hibited amelioration of irritative symptoms within 2 days, 88.9% after 7 days, and 97.2% after 1 month. Conclusions: Subconjunctival bevacizumab injection is useful for the manage ment of patients with recurrent pterygium, with no significant local or systemic adverse effects.

Use of anti‐vascular endothelial growth factor in the management of pterygium

“…Stival et al. () similarly reported significant decreases in pterygium grading, size and mean surface area. The majority of patients’ symptoms also improved.…”

Molecular Basis of Pterygium Development

“…It has been reported that the single postoperative administration of subconjunctival bevacizumab is well tolerated and decreases the number and caliber of corneal blood vessels. 189 Nevertheless, this favorable effect is incomplete and temporary. Other researchers have reported a decrease in the frequency of fibrovascular tissue after bevacizumab treatment, with no statistically significant differences in levels between the treated and non-treated groups.…”

Mechanisms of corneal neovascularization and modern options for its suppression

“…Однако в развитых странах наиболее частой причиной развития слепоты является офтальмогерпес, вызванный Herpes simplex virus (HSV) [10,29,30], и, реже, herpes zoster. Кератит, вызванный вирусом простого герпесаэто иммуноопосредованное заболевание, которое редко возникает при первичном инфицировании.…”

“…Распространение птеригиума в оптическую зону может угрожать зрению и требует хирургического лечения. Рецидивирующий характер течения заболевания и повторные операции могут приводить к истончению роговицы, астигматизму [29,30].…”