Insights into corneal re‐vascularization and vascular remodelling in the eye

Abstract

AbstractWhile corneal neovascularization is a well‐known, sight‐threatening condition presenting a risk for corneal transplant rejection and failure, corneal revascularization has received much less attention. Although ocular revascularization is well studied in the context of regrowth of choroidal vessels following regular anti‐angiogenic injections for age‐related macular degeneration, the corneal context is less well documented. Here, the differences between initial and subsequent episodes of corneal neovascularization are explored, as well as the underlying changes at the mechanistic, structural and biochemical levels, through basic studies in the murine cornea. Repeat neovascularization is found to be more aggressive than the vessel ingrowth in an initial phase, pointing towards a memory effect in the corneal tissue. Furthermore, these regrown vessels are more resistant to treatment than initial vessels, which can have implications for the long‐term treatment and rebound of corneal vessels and prognosis for graft survival. We also highlight several factors that may be driving this aggressive revascularization response, with an eye towards future interventions aimed at preventing revascularization following initial treatments for corneal neovascularization.