Studying the effect of intrastromal anti-vascular endothelial growth factor injections on corneal neovascularization using optical coherence tomography angiography

Author:

Ahmed Ayoub Hussein Mohamed Sherif1,Mousa Amr Saleh2,Hamdi Momen Mahmoud2,Mousa Rasha Mohamed1,Awad-Allah Mo'mena Ahmad A.2

Affiliation:

1. Giza Memorial Institute for Ophthalmic Research, Giza, Egypt

2. Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract

Purpose To evaluate the effect of intrastromal injection of anti-vascular endothelial growth factor (Anti-VEGF) on corneal neovascularization using spectral domain Optical coherence tomography angiography imaging (OCTA). Patients and methods This is a pilot study that was conducted on 10 eyes of 10 patients with corneal neovascularization who were planned for keratoplasty or after keratoplasty. Intrastromal injection of 5 mg/0.2 ml [2.5%] bevacizumab using a 30 Gauge needle was performed. OCTA was done 48 h before the injection, 1 week and 1 month after the injection. OCTA images were compared to evaluate the effect of Anti-VEGF on corneal neovascularization. Results Comparing the OCTA pictures with the preoperative period, at 1 week period, 9 cases have shown decreased corneal neovascularization, with only 1 case that has not changed and seemed to be unresponsive to the single injection of Anti-VEGF. At 1 month period, 8 cases re-vascularized again but none of them reached the preoperative level, 1 case had decreased vascularization (completely disappeared) and 1 case remained the same with no change. Conclusion A single injection of bevacizumab has a temporal effect on corneal neovascularization. No local or systemic complications have been noted. OCTA was able to visualize vessels in 3-D image, even under vascularized corneal scars. OCTA was able to recognize subtle changes in corneal neovascularization that were not visible by slit lamp.

Publisher

Medknow

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