Using synergistic effects in targeting angiogenesis: combination therapy for corneal neovascularization

Abstract

Evaluation of: You IC, Im SK, Lee SH, Yoon KC. Photodynamic therapy with verteporfin combined with subconjunctival injection of bevacizumab for corneal neovascularization. Cornea 30(1), 30–33 (2011).

Corneal neovascularization occurs following infectious, ischemic, inflammatory and other corneal diseases, as well as corneal injuries. It has a detrimental effect on visual acuity and also presents a significant risk for the failure of corneal grafting. To date, the therapeutic modalities are limited and address either the underlying inflammatory and infectious processes or selectively ablate those vessels using photocoagulation or diathermy. More recent strategies include pharmacological inhibition of various steps of angiogenesis and selective photochemical vascular occlusion with photodynamic therapy. The article under evaluation presents a prospective, interventional case series treating corneal neovascularization with a combination of photodynamic therapy and subconjunctival injection of bevacizumab (Avastin™, Genentech Inc., CA, USA). The authors reported success with complete occlusion of vessels in 66.7% of patients at 1 year following a single-session treatment. As with the success seen in treating choroidal neovascularization, this combined approach may offer more effective control and better clinical outcomes. However, further randomized trials are necessary in order to determine optimal dosing, timing as well as the potential local side effects.

Keywords::

• angiogenesis
• anti-VEGF
• bevacizumab
• corneal neovascularization
• photodynamic therapy

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.