Topical Bevacizumab in the Treatment of Corneal Neovascularization

Objective: To study the safety and efficacy of topical bevacizumab in the treatment of corneal neovascularization (NV). Design: In a prospective, open-label, noncomparative study, 10 eyes from 10 patients with stable corneal NV were treated with topical bevacizumab, 1.0%, for 3 weeks and followed up for up to 24 weeks. Main Outcome Measures: The primary safety variables were the occurrence of ocular and systemic adverse events throughout the course of the study. The primary efficacy variables were neovascular area, the area of the corneal vessels themselves; vessel caliber, the mean diameter of the corneal vessels; and invasion area, the fraction of the total corneal area covered by the vessels. Results: From baseline visit to the last follow-up visit, mean reductions were 47.1% (standard deviation [SD], 36.7%) for neovascular area, 54.1% (SD, 28.1%) for vessel caliber, and 12.2% (SD, 42.0%) for invasion area. The decreases in neovascular area and vessel caliber were statistically significant (P=.001 and P <.001, respectively). However, changes in invasion area did not achieve statistical significance (P=.19). Visual acuity and central corneal thickness showed no significant changes. Topical bevacizumab was well tolerated with no adverse events. Conclusions: Short-term topical bevacizumab therapy reduces the severity of corneal NV without local or systemic adverse effects. Application to Clinical Practice: Topical bevacizumab provides an alternative therapy in the treatment of stable corneal NV.