Histologic findings of bevacizumab-treated human conjunctiva in Stevens-Johnson syndrome

To present the histopathologic findings of the conjunctiva of a patient with Stevens-Johnson syndrome (SJS)-associated ocular surface neovascularization (OSN) after topical bevacizumab (TB) treatment.

A 40-year-old man with SJS and OSN received topical bevacizumab (25 mg/mL) for 12 months in 1 eye in addition to previously bilaterally administered tobramycin/dexamethasone eye drops. He subsequently underwent bilateral release of symblephara to relieve diplopia. Conjunctival samples from both eyes were obtained for histopathologic study.

The TB-untreated conjunctiva manifested marked stromal vascularization (approximately 4-5 blood vessels per high-power field) and perivascular mononuclear inflammatory cells. The TB-treated eye manifested with markedly less stromal vascularization (approximately 1-2 vessels per high-power field) in the conjunctiva and absence of perivascular inflammatory cells.

These histopathologic findings provide evidence that TB penetrates the ocular surface, induces regression of OSN, and possibly moderates ocular inflammation. TB may be a useful additional treatment for OSN among patients with SJS.