Title (croatian) Bevacizumab i patologija rožnice
Title (english) Bevacizumab and corneal pathology
Author Marijana Bilen Babić
Author Maja Merlak
Author's institution University of Rijeka Faculty of Medicine (Department of Ophthalmology)
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Ophthalmology
Abstract (croatian) Cilj rada je dati pregled postojeće literature o terapiji bevacizumabom u liječenju neovaskularnih poremećaja rožnice. Rožnica je jedinstveno tkivo zbog svoje prirodne avaskularnosti. Imunoprivilegirano je vezivno tkivo koje služi kao mehanička prepreka i prednja refraktivna površina oka. Krvnu opskrbu prima perilimbalnim cilijarnim arterijama. Neovaskularizacija (NV) rožnice je stanje koje obilježava patološko urastanje perilimbalnih krvnih žila u rožnicu, zbog kroničnog nedostatka kisika. Patološka stanja koja uzrokuju neoangiogenezu rožnice su kemijske ozljede, ishemija, infekcije, degeneracije, trauma i imunološki procesi. Abnormalne krvne žile uzrokuju stvaranje ožiljaka rožnice i kompromitiraju vidnu oštrinu. Neovaskularizacija rožnice nastaje kada je ravnoteža između pro-angiogenih i anti-angiogenih faktora narušena u korist pro-angiogenih molekula. Dosadašnji uobičajeni tretmani za liječenje NV-a rožnice imaju ograničenu kliničku djelotvornost jer ne ciljaju molekularne posrednike angiogeneze. VEGF-A (engl. Vascular Endothelial Growth Factor-A) je glavni regulator hemangiogeneze. Bevacizumab prepoznaje sve VEGF izoforme. Neovaskularna stanja rožnice koja se mogu liječiti bevacizumabom su: inflamatorna stanja, infekcije i traumatski/jatrogeni uzroci. Studije su pokazale djelomično smanjenje neovaskularizacija rožnice kroz topičku, subkonjunktivalnu i intrastromalnu primjenu bevacizumaba. Anti-VEGF terapija stvorila je ogromnu nadu za liječenje neovaskularizacije rožnice, no ona ima svoje granice u liječenju, a uspješnost liječenja ovisi o veličini ožiljka, trajanju bolesti i opsegu neovaskularizacija. Anti-VEGF terapija je posebno učinkovita ako se primijeni u ranoj fazi (prva 2 tjedna neoangiogeneze). Kontrolirane prospektivne studije potrebne su za uspostavu dugoročne sigurnosti i određivanje minimalne efektivne i maksimalne sigurnosne koncentracija bevacizumaba za liječenje NV-a prednjeg segmenta oka.
Abstract (english) The purpose of this paper is to present a review of the current literature on anti-vascular endothelial growth factor (anti-VEGF) bevacizumab therapy for corneal neovascular disorders. Cornea is unique avascular, immunoprivileged connective tissue that acts as transparent mechanical barrier and the anterior eye refractive surface. Corneal neovascularizations (NV) are caused by chronic corneal ischemia with pathological ingrowth of perylimbal blood vessels into the cornea. Abnormal blood vessels cause scarring of the cornea and compromise visual acuity. Pathological conditions that cause corneal neoangiogenesis are: chemical burns, ischemia, infections, degeneration, trauma and immune processes. Corneal neovascularization occurs because of corneal pro-angiogenic and anti-angiogenic factors disequilibrium. The former treatment of corneal NV does not target the molecular mediators of angiogenesis. VEGF-A is the main regulator of angiogenesis. Bevacizumab recognizes all VEGF isoforms. Studies have demonstrated partial reduction of neovascularization through topical, subconjunctival and intrastromal bevacizumab application. Bevacizumab can be used in corneal inflammatory diseases, infections and traumatic/iatrogenic causes. Anti-VEGF agents have created enormous hope for the treatment of corneal neovascularization. Treatment of corneal NV with anti-VEGF antibody has limits and depends on the size of the scar, durability and range of neovascularization. Anti-VEGF agents are especially effective when administered early (less then 2 weeks in neoangiogenesis). Controlled prospective studies are needed to establish long-term safety, efficacy and minimum effective and maximum security concentration of the drug to treat neovascularisation of anterior eye segment.
Keywords (croatian)
bevacizumab
patologija rožnice
rožnica
vaskularni endotelni faktori rasta
Keywords (english)
bevacizumab
cornea
corneal diseases
vascular endothelial growth factors
Language croatian
Publication type Scientific paper - Review paper
Publication status Published
Peer review Peer review
Publication version Published version
Journal title Medicina Fluminensis : Medicina Fluminensis
Numbering vol. 53, no. 2, pp. 204-209
p-ISSN 0025-7729
DOI https://doi.org/10.21860/medflum2017_179759
URN:NBN urn:nbn:hr:184:750658
Publication 2017-06-01
Document URL http://hrcak.srce.hr/179759
Type of resource Text
Access conditions Open access
Terms of use
Created on 2017-06-05 16:25:20