Novel strategies for angioregression at the ocular surface

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The normal human cornea is avascular. This avascularity is actively maintained by expression of antiangiogenic and antilymphangiogenic factors. Corneal neovascularization (NV) can occur after numerous corneal diseases and leads to decreased visual acuity and poor prognosis in subsequent corneal transplantation since corneal immune privilege is lost. We recently demonstrated that bevacizumab eye drops significantly inhibit progressive corneal angiogenesis. In contrast, limited treatment options exist for mature corneal vessels, which — because of their pericyte-covered vessel wall—do not depend on VEGF anymore. Here, we report on the short- and long-term visual acuity changes and changes in vascularized corneal area after e.g. feeder vessel coagulation combined with topical bevacizumab application for the treatment of mature pathological corneal NV. These angioregressive therapies may not only improve corneal transparency but also “preconditions” such a cornea for future keratoplasty.

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