Role of Anti-VEGF in Treatment of Corneal Neovascularization
Mohamed Refaat Awad Helaly;
Abstract
Corneal angiogenesis is associated with the most common forms of corneal blindness both worldwide as well as in developed countries.
Corneal angiogenesis is primarily caused by inflammatory diseases of the cornea (most commonly keratitis), corneal hypoxia (contact lens wear) and limbal antiangiogenic barrier defects (most commonly chemical burns).
Currently, it’s evident that angiogenesis is tightly controlled by two counterbalancing systems: angiogenic stimulating factors and angiogenic inhibiting factors, both present physiologically and kept in balance in normal cornea, whereas corneal NV starts when the balance is shifted towards angiogenic growth factors such as: (VEGF), (PDGF), (FGF), etc.
In corneal inflammation, (hem) angiogenesis (i.e. outgrowth of pathologic blood vessels into the cornea) is usually accompanied by lymphangiogenesis (outgrowth of lymphatic vessels).
Complications of corneal angiogenesis leading to reduced visual acuity include: lipid keratopathy, intrastromal hemorrhage, secondary stromal edema due to leakage from immature blood vessels, in addition corneal angiogenesis makes such a cornea a high-risk recipient bed in the case of subsequent keratoplasty.
Conventional antiangiogenic treatments such as; steroids, cyclosporine A, photodynamic therapy and fine needle diathermy have shown to be effective but on the other hand, have some side effects.
The anti-vascular endothelial growth factor (anti-VEGF) has enjoyed enormous and increasing popularity for its efficacy in shrinking retinal neovessles in patients with proliferative retinopathies. It was natural, therefore, to explore the therapeutic potential of anti-VEGFs in corneal neovascularization.
Anti-VEGFs can be administered topically, subconjunctivally or even by intrastromal injection and seems to be safe and effective.
These antiangiogenic and antilymphangiogenic therapies appear to inhibit corneal NV and improve graft survival after both low-risk and high-risk keratoplasty by reducing the incidence of immune rejections.
Still we are in need for a lot of comparative studies to demonstrate the efficacy of different subtypes of anti-VEGFs in comparison with each other and with other conventional methods.
Corneal angiogenesis is primarily caused by inflammatory diseases of the cornea (most commonly keratitis), corneal hypoxia (contact lens wear) and limbal antiangiogenic barrier defects (most commonly chemical burns).
Currently, it’s evident that angiogenesis is tightly controlled by two counterbalancing systems: angiogenic stimulating factors and angiogenic inhibiting factors, both present physiologically and kept in balance in normal cornea, whereas corneal NV starts when the balance is shifted towards angiogenic growth factors such as: (VEGF), (PDGF), (FGF), etc.
In corneal inflammation, (hem) angiogenesis (i.e. outgrowth of pathologic blood vessels into the cornea) is usually accompanied by lymphangiogenesis (outgrowth of lymphatic vessels).
Complications of corneal angiogenesis leading to reduced visual acuity include: lipid keratopathy, intrastromal hemorrhage, secondary stromal edema due to leakage from immature blood vessels, in addition corneal angiogenesis makes such a cornea a high-risk recipient bed in the case of subsequent keratoplasty.
Conventional antiangiogenic treatments such as; steroids, cyclosporine A, photodynamic therapy and fine needle diathermy have shown to be effective but on the other hand, have some side effects.
The anti-vascular endothelial growth factor (anti-VEGF) has enjoyed enormous and increasing popularity for its efficacy in shrinking retinal neovessles in patients with proliferative retinopathies. It was natural, therefore, to explore the therapeutic potential of anti-VEGFs in corneal neovascularization.
Anti-VEGFs can be administered topically, subconjunctivally or even by intrastromal injection and seems to be safe and effective.
These antiangiogenic and antilymphangiogenic therapies appear to inhibit corneal NV and improve graft survival after both low-risk and high-risk keratoplasty by reducing the incidence of immune rejections.
Still we are in need for a lot of comparative studies to demonstrate the efficacy of different subtypes of anti-VEGFs in comparison with each other and with other conventional methods.
Other data
| Title | Role of Anti-VEGF in Treatment of Corneal Neovascularization | Other Titles | دور مضاد عامل نمو بطانة الأوعية الدموية في علاج الأوعية الدموية المستحدثة بالقرنية | Authors | Mohamed Refaat Awad Helaly | Issue Date | 2014 |
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