Abstract
Objective: To determine the clinical effect of subconjunctival injection of bevacizumab in regression or halting growth in patients with recurrent pterygium.Method and materials: The study was an off-label; 2-dosing, interventional case series involving 20 patients with recurrent pterygium. They received subconjunctival bevacizumab (0.2 ml/2.5 mg). Vascularity and thickness of Pterygium was graded. Size of the pterygium (measured by surface area in cm2) was recorded from baseline to 6 months, after injection. Treatment-related complications and adverse events were reported. The main outcome of measurements was the change in grading, size, vascularity, thickness and color intensity.Results: 9 males (45%) , 11 females (55%) of 20 patients were conducted in study with a mean age of 50.46 years ± 18.30 (rang 38-70). There was a significant reduction in grading with significant difference in the mean surface area of pterygium at different intervals (P<0.05) and the size of pterygium was reduced. The reduction of color intensity was significant (P=0.031). No significant topical or systemic adverse reactions were recorded.Conclusions: Subconjunctival bevacizumab injection is useful in management of patients with recurrent pterygium without significant local or systemic adverse effects.
Highlights
Pterygium is a triangular sheet of fibro vascular tissue that invades the cornea [1,2]
Jin et al showed that pterygia contain drastically decreased levels of pigment epithelium-derived factor, angiogenic inhibitor, and elevated vascular endothelial growth factor (VEGF) levels [15]
This study showed that is no statistically significant difference between males and females in the mean pterygium size (>0.05) during the follow up period
Summary
Pterygium is a triangular sheet of fibro vascular tissue that invades the cornea [1,2]. Recent studies have provided evidence implicating genetic components, antiapoptotic mechanisms, cytokines, growth factors, extracellular matrix remodeling, immunological mechanisms, and viral infections in the pathogenesis of the disease [7,8,9,10,11]. Vascular growth factors such as vascular endothelial growth factor (VEGF) have been detected in pterygium [12,13,14,15].There is marked elevation of VEGF in pterygia in comparison to normal conjunctival samples [12,13,14,15]. Jin et al showed that pterygia contain drastically decreased levels of pigment epithelium-derived factor, angiogenic inhibitor, and elevated VEGF levels [15]
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