Effect of topical cyclosporin A on herpetic stromal keratitis in a mouse model.

PURPOSE: To study the effect of topical cyclosporin A on herpetic stromal keratitis (HSK) in a mouse model. METHODS: The corneas of BALB/c mice were infected with herpes simplex type 1 virus. The mice were divided into 4 groups according to topical treatment methods: vehicle solution, 0.01% cyclosporin A, 0.1% cyclosporin A, and 1% cyclosporin A. The severity of stromal keratitis was graded clinically at 3, 7, 10, and 14 days after treatment. Histologic and immunohistochemical examinations were performed to analyze infiltrating inflammatory cells and T lymphocytes at 14 days after treatment. Flow cytometry was performed to count CD4 T cells at 14 days after treatment. RESULTS: On day 3 after treatment, there were no significant differences in mean severity scores of HSK between the vehicle and cyclosporin A-treated groups. On days 7, 10, and 14, the severity scores in the groups treated with 0.1% or 1% cyclosporin A decreased significantly compared with the vehicle group (P < 0.05). However, the scores in the group treated with 0.01% cyclosporin A did not change up to 14 days after treatment. By histologic and immunohistochemical analysis, a significant decrease in the total number of inflammatory cells and T lymphocytes was detected in the groups treated with 0.1% or 1% cyclosporin A. Flow cytometry also showed similar findings. CONCLUSIONS: Topical cyclosporin A effectively reduces stromal haze and inflammation in experimental HSK, and cyclosporin A eyedrops with a >0.1% concentration can be used for the treatment of HSK.

Photodynamic therapy with verteporfin for corneal neovascularization.

PURPOSE: To investigate the efficacy of photodynamic therapy with verteporfin for the treatment of patients with corneal neovascularization. DESIGN: Prospective interventional case series. METHODS: Eighteen eyes of 18 patients with stable corneal neovascularization who were refractory to conventional treatment were treated with photodynamic therapy with verteporfin (6 mg/m(2)). Five patients were treated following penetrating keratoplasty (PK), and two patients were treated before PK. Anterior segment photography was performed before and after treatment. Best-corrected visual acuity (BCVA) and area of corneal neovascularization were measured. RESULTS: At the one-year follow-up, 14 eyes (77.8%) showed a decrease in corneal neovascularization, and nine eyes (50.0%) showed complete vascular occlusion. In five patients who had corneal allograft, complete or partial occlusion was achieved in all eyes. Two patients who underwent subsequent keratoplasty did not manifest allograft rejection or revascularization. Seventeen eyes (94.4%) had stable or improved vision. The mean area of corneal neovascularization significantly decreased from 25.5 +/- 14.2 mm(2) to 14.9 +/- 14.6 mm(2) (P < .01), respectively. No significant complications associated with photodynamic therapy were observed except mild stromal haze in one eye. CONCLUSION: Photodynamic therapy with verteporfin may be effective for the treatment of corneal neovascularization.

Therapeutic effect of subconjunctival injection of bevacizumab in the treatment of corneal neovascularization.

PURPOSE: To investigate the efficacy of subconjunctival injection of bevacizumab in the treatment of patients with corneal neovascularization. METHODS: Twenty-nine eyes of 29 patients with corneal neovascularization were treated with subconjunctival injection [1.25 mg/0.05 ml (seven eyes), 2.5 mg/0.1 ml (15 eyes) and 5.0 mg/0.2 ml (seven eyes)] of bevacizumab. Best-corrected visual acuity, intraocular pressure and area of corneal neovascularization were measured before injection and at 1 week, 1 month and 3 months after treatment. RESULTS: At 1 week, the mean neovascularized corneal area decreased significantly to 85.5 +/- 18.0% (p = 0.01) in the eyes treated with 2.5 mg bevacizumab and to 73.1 +/- 23.4% (p = 0.02) in the eyes treated with 5.0 mg bevacizumab. At 3 months, the mean neovascularized corneal area was 93.6 +/- 10.6% (p = 0.10 compared to baseline; p < 0.01 compared to 1 week) in the eyes treated with 2.5 mg bevacizumab and 83.3 +/- 25.8% (p = 0.03 compared to baseline; p = 0.02 compared to 1 week) in the eyes treated with 5.0 mg bevacizumab. However, there were no significant changes in the areas of the eyes injected with 1.25 mg bevacizumab. CONCLUSION: Subconjunctival injection of bevacizumab can partially reduce corneal neovascularization in the short term, and the efficacy of this treatment correlates with the injection dose.