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Effectiveness of photodynamic therapy with verteporfin combined with intrastromal bevacizumab for corneal neovascularization in Stevens-Johnson syndrome

 Hyeon Jeong Yoon  ;  Mee Kum Kim  ;  Kyung Yul Seo  ;  Mayumi Ueta  ;  Kyung Chul Yoon 
 INTERNATIONAL OPHTHALMOLOGY , Vol.39(1) : 55-62, 2019 
Journal Title
Issue Date
Adult ; Aged ; Angiogenesis Inhibitors/administration & dosage ; Bevacizumab/administration & dosage* ; Corneal Neovascularization/diagnosis ; Corneal Neovascularization/drug therapy* ; Corneal Neovascularization/etiology ; Corneal Stroma ; Dose-Response Relationship, Drug ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Injections ; Male ; Middle Aged ; Photochemotherapy/methods* ; Photosensitizing Agents/administration & dosage ; Slit Lamp Microscopy ; Stevens-Johnson Syndrome/complications* ; Stevens-Johnson Syndrome/diagnosis ; Stevens-Johnson Syndrome/drug therapy ; Treatment Outcome ; Verteporfin/administration & dosage* ; Visual Acuity
Corneal neovascularization ; Intrastromal injection of bevacizumab ; Photodynamic therapy ; Steven–Johnson syndrome
PURPOSE: To investigate the effectiveness of combined photodynamic therapy with verteporfin and intrastromal injection of bevacizumab for the treatment of corneal neovascularization in patients with Stevens-Johnson syndrome (SJS).

METHODS: Eight eyes of eight patients with SJS having corneal neovascularization who were refractory to 1% prednisolone instillation received photodynamic therapy with verteporfin (6 mg/m2) combined with intrastromal bevacizumab injection (2.5 mg/0.1 mL). Best-corrected visual acuity and intraocular pressure were assessed, and slit-lamp biomicroscopic examination was performed before treatment and at 1 week and every month. A chronic ocular manifestation score was assigned based on the involvement area or the severity before treatment. The cumulative length of corneal blood vessels and area of corneal neovascularization were measured by anterior segment photographs before and after treatment.

RESULTS: At 3 and 6 months after treatment, all eyes showed regression of corneal neovascularization. Complete regression was achieved in five eyes (62.5%) and partial regression in three eyes (37.5%). Among five patients who were followed up for more than 1 year, two eyes maintained complete regression and one eye maintained partial regression at 1 year. However, two eyes with severe chronic ocular manifestation showed revascularization.

CONCLUSIONS: Combined photodynamic therapy with intrastromal bevacizumab injection can effectively inhibit corneal neovascularization in patients with SJS. However, patients with severe chronic ocular manifestation may exhibit revascularization.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Seo, Kyoung Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
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