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Anti-VEGF therapy (bevacizumab) for sulfur mustard-induced corneal neovascularization associated with delayed limbal stem cell deficiency in rabbits

TitleAnti-VEGF therapy (bevacizumab) for sulfur mustard-induced corneal neovascularization associated with delayed limbal stem cell deficiency in rabbits
Publication TypeJournal Article
Year of Publication2014
AuthorsKadar T., Amir A., Cohen L., Cohen M., Sahar R., Gutman H., Horwitz V., Dachir S.
JournalCurr Eye ResCurr Eye ResCurr Eye Res
Date PublishedMay
ISBN Number1460-2202 (Electronic)<br/>0271-3683 (Linking)
Accession Number24215293
KeywordsAngiogenesis Inhibitors/*pharmacology, Animals, Antibodies, Monoclonal, Humanized/*pharmacology, Cornea/drug effects/metabolism/pathology, Corneal Neovascularization/*chemically induced/*drug therapy/pathology, Dermatologic Agents/pharmacology, Female, Limbus Corneae/drug effects/metabolism/pathology, Mustard Gas/*pharmacology, Rabbits, Stem Cells/*pathology, Vascular Endothelial Growth Factor A/antagonists & inhibitors/metabolism

PURPOSE: To investigate the involvement of VEGF in corneal neovascularization (CNV) following sulfur mustard (SM) exposure and to test the therapeutic effects of bevacizumab (Avastin) in respect to dose, route of administration and timing. MATERIALS AND METHODS: Topical bevacizumab (6 or 25 mg/ml, x2/day) was applied to rabbit eyes, before or after appearance of NV, following SM vapor exposure, and was compared with subconjunctival injection (25 mg/ml, x2/week) and topical dexamethasone (1%, x4/day). Treatments were given for 3 weeks. VEGF levels were monitored by immunohistochemistry and ELISA assay. Clinical evaluations included slit-lamp examination, impression cytology for diagnosis of Limbal Stem Cell Deficiency (LSCD), pachymetry, measurement of NV length and histology. RESULTS: Corneal NV was developed, as early as 2 weeks after exposure, in 50-70% of the eyes, associated with increased levels of VEGF. Topical bevacizumab treatment with both doses, starting at 4 weeks, reduced vascularization. Subconjunctival injection and topical dexamethasone were more potent. A combined treatment of dexamethasone and bevacizumab improved the anti-angiogenic efficacy, yet, there was no effect on LSCD. Topical bevacizumab treatment starting at 1 week, when VEGF was elevated but before appearance of NV, had no effect. CONCLUSIONS: VEGF was involved in corneal angiogenesis in SM-induced ocular injury. Bevacizumab was beneficial in reducing CNV by both, topical or subconjunctival injection, when given as a symptomatic therapy with or without dexamethasone, however with no effect on SC deficiency. Further studies on the pathological mechanism of SM-induced ocular surface disorder may direct towards improved therapy.

Short TitleCurrent eye researchCurrent eye research
Alternate JournalCurrent eye research

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