Ocular Microbiology and Immunology Group
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2018 OMIG Abstract

Long-term Outcome of Prosthetic Replacement of Ocular Surface Ecosystem (PROSE) for Delivery of Bevacizumab in the Treatment of Corneal Neovascularization

Jia Yin MD PhD and Deborah S. Jacobs MD
Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA

Methods: Retrospective, non-comparative, interventional case series of 13 sequential patients treated for KNV at the Boston Foundation for Sight between 2006 and 2018. All patients wore PROSE regularly prior to bevacizumab treatment. Patients applied a drop of bevacizumab, 1% preservative free, to the reservoir of PROSE device twice daily except for one case of once daily bilateral use. Patients continued with daily wear of a PROSE device during treatment with bevacizumab and afterwards, indefinitely.

Results: 13 patients (8 female and mean age of 45 years) are reported with a mean follow-up of 5.1 years (range 6 months to 11 years). In all cases, PROSE treatment was initiated for management of ocular surface disease, and not specifically for treatment of corneal neovascularization. Underlying ocular diagnoses included Stevens-Johnson syndrome (7), ocular chronic graft-versus-host disease (2), corneal transplant (2, 1 penetrating keratoplasty for herpes simplex keratitis, and 1 patch graft secondary for Sjogren-related sterile melt), contact lens-related corneal ulcer and limbal stem cell deficiency (1) and familial dysautonomia (1). Median duration of bevacizumab use was 6 months (range 3 months to 10 years). Best-corrected visual acuity (BCVA) improved from -1.1 (LogMAR) at baseline, to -0.66 at end of bevacizumab treatment, and remained -0.63 at last follow-up (P=0.047 repeated measures ANOVA test). Twelve cases (92%) had regression of KNV and 10 cases (77%) had improved BCVA with treatment. KNV progressed in one eye after discontinuation of 10-year use of bevacizumab. No other cases had KNV progression. There were no ophthalmic or systemic complications.

Conclusion: Topical bevacizumab used in PROSE is effective in treating KNV and improving vision. Long-term follow-up reveals durable response and no complications that could be attributed to use of bevacizumab in this manner.

Disclosure: S (JY)

Support: This work was supported by the National Eye Institute 5K12EY016335 (JY, trainee). The sponsor or funding organization had no role in the design or conduct of this research.

2018 Agenda and Abstracts | < Previous Next >