Anti-VEGF Treatment in Corneal Diseases

Background: Corneal neovascularization (CN) is a clue feature of different ocular pathological conditions and can lead to corneal edema and opacification with subsequent vision loss. Vascular endothelial growth factor (VEGF), which plays a key role in new vessels formation, proliferation and migration, was found to be up-regulated in these conditions. Nowadays, it is possible to down-regulate the angiogenic process by using anti-VEGF agents administered through different routes. Objective: To evaluate efficacy, safety and possible future directions of anti-VEGF agents used for the treatment of CN owing to different aetiologies. Methods: A computerized search of articles dealing with the topic of anti-VEGF therapy in CN was conducted in PubMed, Scopus and Medline electronic databases. The following key phrases were used: anti-VEGF agents, corneal neovascularization, bevacizumab, ranibizumab, vascular endothelial grow factor, angiogenesis. Results: The use of anti-VEGF therapy in the treatment of CN reduced pathological vessels density without causing significant side effects. Various administration routes such as topic, subconjunctival and intrastromal ones are available, and the choice depends on patient and disease characteristics. Higher effectiveness is achieved in case of early administration, before mature and well-established vessels take place. In severe or recurrent cases, multiple cycles of anti-VEGF agents can be required in order to obtain and maintain the regression of CN. Conclusion: The efficacy and safety of anti-VEGF agents support their adoption into the daily clinical practice for the management of CN.