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Effect of combined topical heparin and steroid on corneal neovascularization in children
Rike Michels1, Stephan Michels, Stephan Kaminski
1Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland.
Insights
Topical heparin and steroid eye drops effectively treat corneal neovascularization (CN) in children, leading to rapid regression. This combination therapy is safe and well-tolerated, offering a promising option for pediatric eye conditions.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Angiogenesis Research
Background:
- Corneal neovascularization (CN) poses a significant risk for vision loss in children.
- Limited effective therapeutic options exist for pediatric CN.
- Amblyopia is a common complication associated with CN, especially with optical axis involvement.
Observation:
- A combination therapy of topical heparin and a steroid (rimexolone or dexamethasone) was administered to five eyes across four children with progressive CN.
- Treatment involved daily topical application until complete regression of CN was achieved.
- Regression was monitored using slit-lamp examinations and anterior segment photography.
Findings:
- Complete regression of CN was observed in all five treated eyes within five months.
- An anti-angiogenic effect was evident as early as one week into treatment.
- The combination therapy demonstrated a favorable safety profile, with no ocular or systemic side effects reported.
- Recurrence occurred in two eyes post-treatment but responded well to re-treatment.
Implications:
- Topical heparin and steroid combination therapy offers a rapid and effective treatment for pediatric corneal neovascularization.
- This approach is particularly valuable for children with limited treatment alternatives and high amblyopia risk.
- The findings support the use of this combination as a promising therapeutic strategy in pediatric ophthalmology.
Background And Objective:
To demonstrate the effect of topical heparin combined with topical steroid on corneal neovascularization (CN) in children.
Patients And Methods:
Four children (5 eyes) with new-onset progressive CN in at least one eye received topical rimexolone or dexamethasone in combination with heparin until complete regression of CN was obtained. The regression of CN was documented by slit-lamp or anterior segment photography.
Results:
All 5 eyes showed complete regression of CN within 5 months. An anti-angiogenic effect was found as early as 1 week after starting topical combination treatment. No ocular and systemic side effects were detected and treatment was well tolerated by all children. In the 3 eyes with involvement of the optical axis, symmetrical visual acuity was obtained by amblyopia treatment. Recurrence of the CN was detectable in 2 eyes at 1 and 6 months, respectively, after ending combination therapy. Both eyes responded favorably to re-treatment.
Conclusion:
Combination of topical heparin and steroid leads to rapid regression and complete inactivity of CN. This therapeutic approach is promising, especially in children with limited therapeutic alternatives and a high risk for amblyopia.
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