Rama B, Lokaj AS. Multiple subconjunctival Bevacizumab injections forrecurrent pterygium. Case
Study and Case Report
2017; 7(1): 5 - 14.
ABSTRACT
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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