A new oct sign of invasive squamous cell carcinoma of the cornea.

CASE REPORT: A case is reported of an unusual progressive corneal opacification and neovascularization caused by a squamous cell carcinoma (SCC) of the cornea. A patient with a white stromal infiltrate, consistent with herpetic stromal keratitis, showed a very particular image in optical coherence tomography (OCT), resembling a "tongue of lava" sliding between corneal lamellae. Histopathological analysis confirmed the diagnosis of SCC. DISCUSSION: To our knowledge this is the first report in the literature of this peculiar image with OCT. Squamous Cell Carcinoma is an extremely rare cause of progressive corneal opacification and neovascularization, and a delayed diagnosis may lead to unsuccessful treatment and loss of the eyeball.

Neovascular growth in an experimental alkali corneal burn model.

OBJECTIVE: To analyse the length and area of corneal surface occupied by vessels, and their location in an experimental model of alkali burn-induced corneal neovascularization. METHODS: An injury to the central cornea of the right eye in 91 Sprague-Dawley rats was induced using a silver nitrate pencil. The rats were divided in 7 groups that were sacrificed 2, 4, 6, 8, 10, 12 and 14 days post-injury, and then perfused with a mixture of Chinese ink in PBS -phosphate buffer saline-. Corneas were flat-mounted processed and divided in 4 quadrants. Corneal neovascular growth parameters (length and area) and the location of these vessels were performed blind. The results were statistically analysed. RESULTS: Neovascular growth was observed from day 2, reaching its maximum peak in length and area on the 12th day post-injury. A slight reduction in corneal neovascularization was observed after this day. The vessels were initially located in the middle third of the stroma and tended to be observed in the anterior third during the course of the experiment. CONCLUSIONS: Neovascularisation was observed on day 2 post-injury in all sectors of corneal surface. Neovascular growth was uniform during the experiment. Neovessels were located in the middle and anterior third of the cornea.

Bevacizumab subconjuntival y su efectividad en la regresión de la neovascularización corneal evaluado mediante angiografía fluoresceínica de segmento anterior / Subconjunctival bevacizumab effectiveness in corneal neovascularization regression evaluated with anterior segment fluorescein angiography

Objetivo: evaluar objetivamente mediante el uso de angiografía de segmento anterior la reducción del grado de neovascularización corneal con la aplicación de bevacizumab subconjuntival. Diseño: serie de casos con intervención. Metodología: nueve ojos con neovascularización corneal estromal secundaria a diferentes condiciones se sometieron a la realización de angiografía fluoresceínica de segmento anterior; cuatro semanas después se aplicaron 3 dosis de bevacizumab subconjuntival limbar de 2,5 mg/0,1cc cada una sobre el cuadrante comprometido con un intervalo de un mes entre cada aplicación. Cuatro semanas después se realizó una nueva angiografía. Las fotos pre-aplicación y post aplicación fueron analizadas por 3 evaluadores. Se definió como mejoría si había una mejoría ≥30%, basado en una escala de mejoría de 0 a 10. Resultados: se encontró un alto rango de variabilidad en la regresión de la neovascularización corneal (entre 3% y 92%) con un promedio de mejoría del 41% y posibilidad de falla de 44,4% independientemente de su etiología. Se obtuvieron pobres resultados en presencia de cuerpos extraños en córnea (segmentos intraestromales o suturas corneales) con una mejoría entre 3% y 7%. Pacientes sin cuerpo extraño en córnea obtuvieron una mejoría promedio de la neovascuarización corneal del 70%. No hubo efectos secundarios sistémicos o locales. Conclusion: el uso del bevacizumab subconjuntival como terapia antiangiogénica es una alternativa con buena tasa de efectividad en pacientes con neovascularización corneal sin presencia de cuerpos extraños corneales.

Purpose: to assess corneal stromal neovascularization accurately and its improvement by using anterior segment fluorescein angiography imaging after subconjunctival bevacizumab injection. Design: interventional case series. Methodology: an anterior segment fluorescein angiography was performed in nine eyes with stromal neovascularization secondary to different etiologies. Patients underwent subconjunctival bevacizumab injections, each one receiving three injections containing 2,5mg/0,1ml bevacizumab each, at monthly intervals. Four weeks after the last injection was applied, a new anterior segment fluorescein angiography was done; pre and post-treatment angiographies were analyzed by three ophthalmologists. A favorable outcome was defined as an improvement of 30% in corneal neovascularization based on a previously established score from 0 to 10. Results: findings were variable, with corneal neovascularization improving between 3% and 92% (mean improvement 41%) for all eyes included, and a 44,4% chance of failure. Poor results were obtained from eyes that had some type of intracorneal foreign body such as intracorneal ring segments (ICRS) and corneal sutures with an improvement range from 3% to 7% whereas eyes with no foreign bodies had a mean reduction in corneal neovascularization of 70%. No side effects were reported. Conclusions: subconjunctival Bevacizumab use as antiangiogenic therapy is an alternative with a high success rate in patients without intracorneal foreign bodies, although it is clearly not as effective in patients with foreing body-induced neovascularization.

[Vascular morphological and microdensity changes of corneal neovascularization induced by topical bevacizumab and sunitinib in an animal model]. / Cambios en la morfología y la microdensidad neovascular corneal inducidos tras la administración tópica de bevacizumab y sunitinib en un modelo animal.

OBJECTIVE: To evaluate the effects of topical bevacizumab and topical sunitinib on vascular microdensity and morphology of corneal neovascularization (NV). METHODS: A total of 33 rabbits were distributed into 3 groups: group 1 (control; n=11): saline; group 2 (n=11): bevacizumab 5mg/ml; and group 3 (n=11): sunitinib 0.5mg/ml. A corneal NV model was used, based on sutures in the right eye of each rabbit. Each treatment was administered topically 3 times daily for 14 days. Corneas were then processed for the study of vascular microdensity (6 eyes) and vascular morphology analysis (5 eyes) using enzymatic staining histological techniques RESULTS: The vascular response in group 3 was limited to small-sized tree formations with various vascular axes compared with the extensive, lush and directional corneal NV of group 1 and 2. In the histological sections near the limb, there were no differences in vascular microdensity studies between the three groups. However, the mean sectional area of vessels (MSAV) in group 3 was 41.88% lower than in group 1 and 19.19% lower than in group 2. In distal sections, there were no differences between groups 1 and 2. However, group 3 was characterized by absence of vessels. CONCLUSIONS: Bevacizumab produced no changes in the morphology of the vessels or the vascular microdensity. Sunitinib reduced the size of the new vessels and induced changes in the vascular tree.

Utilización del bevacizumab en la neovascularización corneal / Use of Bevacizumab in corneal neovascularization

La neovascularización corneal es causa de pérdida de su transparencia y también es un factor de riesgo para el rechazo secundario de trasplantes en esa estructura. El bevacizumab es un anticuerpo monoclonal humanizado que bloquea selectivamente la cascada de formación del VEGF y con esto disminuye la formación de vasos sanguíneos...

Neovascularization of the cornea is a cause of loss of transparency of the same and is also a risk factor for secondary rejection corneal transplants. Bevacizumab is a humanized monoclonal antibody that selectively blocks the formation of the VEGF cascade and, with this, decreases the formation of blood vessels...

Utilización del bevacizumab en la neovascularización corneal / Use of Bevacizumab in corneal neovascularization

La neovascularización corneal es causa de pérdida de su transparencia y también es un factor de riesgo para el rechazo secundario de trasplantes en esa estructura. El bevacizumab es un anticuerpo monoclonal humanizado que bloquea selectivamente la cascada de formación del VEGF y con esto disminuye la formación de vasos sanguíneos...

Neovascularization of the cornea is a cause of loss of transparency of the same and is also a risk factor for secondary rejection corneal transplants. Bevacizumab is a humanized monoclonal antibody that selectively blocks the formation of the VEGF cascade and, with this, decreases the formation of blood vessels...