الفهرس 
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Abstract
pterygium is a common external ocular disease that is characterized by fibrovascular overgrowth of the bulbar conjunctival tissue onto the cornea. It is a common disorder of the ocular surface, with a prevalence of 2% in temperate areas and up to 20% in tropical regions.
The pathogenesis behind its formation is not fully understood. It has been well established that there are different interrelated factors involved in the growth of pterygia. Several studies have evaluated the role of VEGF in pterygium pathogenesis, and have demonstrated elevated levels in pterygium tissue as compared to normal conjunctivae.
Despite evolution and modification of pterygium excision techniques, recurrence continues to be a limiting factor to success and represents a significant surgical problem. The various treatments for pterygia are aimed at reducing recurrence of the lesion. The challenge continues to find an adjunctive agent with long term safety and efficacy.
The over expression of VEGF in pterygium tissue led to the development of anti-angiogenic/anti-VEGF therapy to induce regression of blood vessels and hence retard progression of pterygium.
The aim of this study was to review the role of anti-VEGF drugs in the management of pterygium.
It was found that a single administration of subconjunctival bevacizumab to a primary pterygium was well tolerated and reduced irritation and inflammation for a short term. The transient effect was likely related to the limited bioavailability of the drug in the setting of continued VEGF expression. However, subconjunctival bevacizumab injection showed promise in inducing regression in pterygium vascularity and thickness.
Subconjunctival injection of ranibizumab in conjunction with pterygium surgery was well tolerated.
Regarding pterygium recurrence, the use of Bevacizumab through subconjunctival injection or topical administration, seemed to be safe and effective for delaying the time of primary pterygium recurrence. However, it could not lead to its regression.
Future multicenter studies will be required to determine the appropriate dosing schedule of anti-VEGF treatment, and the value of its combination with drugs targeting alternate cytokines and growth factors.