Subconjunctival aflibercept inhibits corneal angiogenesis and VEGFR-3⁺CD11b⁺ cells

This study aimed to investigate the effects of subconjunctival injection of aflibercept, a soluble protein decoy for VEGFR-1 and VEGFR-2, on corneal angiogenesis and VEGFR-expressing CD11b⁺ cells in a mouse model of suture-induced corneal neovascularization.

Corneal neovascularization was induced in BALB/c mice by placing three sutures on the cornea. Immediately after surgery, either 200 µg aflibercept (5 µL) or an equal volume of phosphate-buffered saline (PBS) was administered into the subconjunctival space. Seven days after later, corneal new vessels were quantified through clinical examination and measurement of the CD31-stained area in corneal flat mounts. The levels of pro-angiogenic and inflammatory markers in the cornea were evaluated using RT-qPCR. The percentages of VEGFR-2⁺CD11b⁺ cells and VEGFR-3⁺CD11b⁺ cells were analyzed in the cornea, blood, and draining cervical lymph nodes (DLNs) using flow cytometry.

Subconjunctival injection of aflibercept significantly reduced the growth of corneal new vessels compared to subconjunctival PBS injection. The mRNA levels of Cd31, vascular growth factors (Vegfc and Angpt1), and pro-angiogenic/inflammatory markers (Tek/Tie2, Mrc1, Mrc2, and Il6) in the cornea were downregulated by subconjunctival aflibercept. Also, the percentage of VEGFR-3⁺CD11b⁺ cells in the cornea, blood, and DLNs was decreased by aflibercept, whereas that of VEGFR-2⁺CD11b⁺ cells was unaffected.

Subconjunctival aflibercept administration inhibits inflammatory angiogenesis in the cornea and reduces the numbers of cornea-infiltrating and circulating VEGFR-3⁺CD11b⁺ cells.