Rama B, Lokaj AS. Multiple subconjunctival Bevacizumab injections forrecurrent pterygium. Case Study and Case Report 2017; 7(1): 5 - 14.
A pterygium is defined as a triangular ocular surface lesion growing from conjunctiva towards limbus cornea and corneal surface. It is also characterized as fibrovascular growth, hyperplastic epithelial proliferation and tissue degeneration leading to persistent chronic inflammation. It usually appears more frequently in patients who live in hot climate and constant sun or ultraviolet exposure. Other risk factors are toxic material exposure, dry eye and familiar predisposition. There are 4 types of pterygium basing on its extension on corneal surface. Irritation and visual acuity problems are the most common symptoms in advanced stages, but small lesions can be asymptomatic. Although the pathogenesis is not yet clearly understood, it is considered as chronic cellular proliferation caused by transforming growth factor, (TGF)-β1 known as one of the main mediators of fibroblast stimulation and vascular endothelial growth factor, VEGF the main role factor mediator of angiogenesis and fibroblast stimulation. In our study we represent a case series of patient treated with subconjuctival Bevacizumab injections for ten weeks. Over expression of the vascular endothelial growth factor (VEGF) associated with intense angiogenesis process shows that it is an obvious factor which with significant role in pterygium development. There is possible adjuvant therapy for pterygium treatment. Bevacizumab is anti-VEGF, a human monoclonal antibody against VEGF with anti angiogenic effect which decreases fibrovascular invasion and migration and decreases the fibroblast expression. It is used in ophthalmology as an off-label treatment for retinal disease and also pterygium treatment. We represent the effectiveness of multiple Bevacisumab injections in pterygium. Based on our evaluation of the case series with subconjuctival Bevacizumab injections without following surgery, we came to the conclusion that there are no significant changes in recurrence of pterygium.
Keywords: Recurrent pterygium, suconjunctival bevacizumab
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