TO STUDY THE EFFECT OF INTRASTROMAL VS SUBCONJUNCTIVAL ANTI VASCULAR ENDOTHELIAL GROWTH FACTOR AGENT BEVACIZUMAB IN CORNEAL NEOVASCULARIZATION”

Abstract

Background: Corneal neovascularization (CoNV) impairs visual function by disrupting corneal clarity, prompting the use of targeted anti-VEGF therapies. This study compares the clinical efficacy and safety of subconjunctival versus intrastromal administration of bevacizumab in managing CoNV. Methods: This prospective, interventional study enrolled 70 eyes diagnosed with CoNV, which were equally randomized into Group A (subconjunctival injection, n=35) and Group B (intrastromal injection, n=35). Day 28 outcomes were evaluated by measuring Best Corrected Visual Acuity (BCVA), monitoring for adverse events, and calculating a composite CoNV severity score based on involved quadrants, vessel density, and vessel length. Results: Both groups exhibited substantial vascular regression, with the mean total treatment score decreasing from 8.4 ± 2.03 at baseline to 6.42 ± 1.80 at Day 28 (p < 0.001). Group B demonstrated significantly better anatomical outcomes than Group A, achieving fewer vessels per quadrant (1.62 ± 0.54 vs 1.97 ± 0.74; p = 0.032) and a lower composite treatment score (6.0 ± 1.32 vs 6.85 ± 2.14; p = 0.048). Functionally, Group B achieved statistically significant BCVA improvement (p = 0.0448), whereas Group A's improvement was not statistically significant. Regarding safety, 14.3% of Group A experienced subconjunctival hemorrhage, while Group B reported zero adverse events. Conclusion: Both administration routes effectively regress CoNV, but intrastromal delivery provides superior structural regression, significant visual recovery, and fewer localized bleeding complications.