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Corneal neovascularization
J H Chang1, E E Gabison, T Kato
1Schepens Eye Research Institute and the Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts 02114, USA.
Abstract:
Corneal neovascularization (NV) is a sight-threatening condition usually associated with inflammatory or infectious disorders of the ocular surface. It has been shown in the field of cancer angiogenesis research that a balance exists between angiogenic factors (such as fibroblast growth factor and vascular endothelial growth factor) and anti-angiogenic molecules (such as angiostatin, endostatin, or pigment epithelium derived factor) in the cornea. Several inflammatory, infectious, degenerative, and traumatic disorders are associated with corneal NV, in which the balance is tilted towards angiogenesis. The pathogenesis of corneal NV may be influenced by matrix metalloproteinases and other proteolytic enzymes. New medical and surgical treatments, including angiostatic steroids, nonsteroidal inflammatory agents, argon laser photocoagulation, and photodynamic therapy have been effective in animal models to inhibit corneal NV and transiently restore corneal "angiogenic privilege."
Insights
Corneal neovascularization (NV), a cause of vision loss, occurs when the balance of angiogenic factors is disrupted. Treatments targeting this imbalance show promise in animal models for inhibiting NV.
Area of Science:
- Ophthalmology
- Angiogenesis Research
- Corneal Disease
Background:
- Corneal neovascularization (NV) is a significant cause of vision impairment, often linked to ocular surface inflammation or infection.
- A delicate balance between pro-angiogenic factors (e.g., FGF, VEGF) and anti-angiogenic molecules (e.g., angiostatin, endostatin) normally maintains the cornea's avascular state.
- Disruptions in this balance, favoring angiogenesis, are implicated in various corneal disorders, including inflammatory, infectious, degenerative, and traumatic conditions.
Purpose of the Study:
- To explore the pathogenesis of corneal neovascularization (NV).
- To review the role of angiogenic and anti-angiogenic factors in corneal NV.
- To summarize current and emerging treatments for corneal NV.
Main Methods:
- Review of existing literature on corneal neovascularization (NV) and angiogenesis.
- Analysis of the role of growth factors, anti-angiogenic molecules, and matrix metalloproteinases in corneal NV.
- Evaluation of the efficacy of various medical and surgical treatments in preclinical models.
Main Results:
- Corneal NV results from an imbalance favoring angiogenic factors over anti-angiogenic molecules.
- Matrix metalloproteinases and proteolytic enzymes may contribute to the pathogenesis of corneal NV.
- Several therapeutic strategies, including angiostatic steroids, NSAIDs, laser photocoagulation, and photodynamic therapy, have demonstrated efficacy in inhibiting corneal NV in animal models.
Conclusions:
- Corneal neovascularization (NV) is a complex process driven by an angiogenic imbalance.
- Targeting angiogenic pathways offers potential therapeutic strategies for sight-threatening corneal NV.
- Further research and clinical translation are needed to restore corneal avascularity and preserve vision.