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Related Concept Videos

Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Open Angle Glaucoma: Treatment01:27

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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
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Related Experiment Video

Updated: Sep 28, 2025

Three-dimensional Angiogenesis Assay System using Co-culture Spheroids Formed by Endothelial Colony Forming Cells and Mesenchymal Stem Cells
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Bevacizumab in High-Risk Corneal Transplantation: A Pilot Multicenter Prospective Randomized Control Trial.

Thomas H Dohlman1, Matthew McSoley1, Francisco Amparo1

  • 1Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.

Ophthalmology
|March 31, 2022
PubMed
Summary

Local bevacizumab (Avastin) showed a positive trend in reducing rejection after high-risk corneal transplants, though not statistically significant in the primary analysis. Further study is needed to confirm its efficacy in preventing endothelial rejection.

Keywords:
AngiogenesisCorneal transplantationNeovascularizationPenetrating keratoplastyVascular endothelial growth factor

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Area of Science:

  • Ophthalmology
  • Transplantation Immunology
  • Vascular Biology

Background:

  • High-risk corneal transplantation is often complicated by neovascularization (NV).
  • Endothelial rejection remains a significant concern following corneal grafts, particularly in vascularized eyes.
  • Bevacizumab (Avastin) is an anti-vascular endothelial growth factor (VEGF) agent with potential anti-angiogenic and anti-inflammatory properties.

Purpose of the Study:

  • To evaluate the efficacy of local (subconjunctival and topical) bevacizumab in preventing endothelial rejection after vascularized high-risk corneal transplantation.
  • To assess the safety and tolerability of bevacizumab in this patient population.

Main Methods:

  • A pilot, prospective, randomized, double-blind, placebo-controlled trial was conducted across 5 centers in the US, India, and Brazil.
  • Patients (>18 years) with high-risk penetrating keratoplasty (defined by corneal NV) were randomized.
  • Participants received either subconjunctival bevacizumab (2.5 mg) or placebo at surgery, followed by topical bevacizumab (10 mg/ml) or placebo drops four times daily for 4 weeks.

Main Results:

  • Ninety-two patients were randomized. The 52-week endothelial rejection rate was 10% for bevacizumab versus 19% for placebo (P=0.20).
  • Post hoc analysis at the lead site revealed a significantly lower rejection rate in the bevacizumab group (3% vs. 38%, P=0.003).
  • A post hoc Cox regression analysis indicated a hazard ratio of 0.15 (P=0.01) for bevacizumab treatment.

Conclusions:

  • The study did not meet its primary endpoint, showing no statistically significant difference in endothelial rejection rates at 1 year between bevacizumab and placebo groups.
  • The trial may have been underpowered to detect a statistically significant difference.
  • Data suggest a potential positive effect of bevacizumab on endothelial rejection, warranting further investigation with larger trials and optimized treatment designs.