When the eye is deprived of oxygen, new blood vessels develop in the cornea. The result is reduced transparency leading to an eventual loss of vision. The condition is called neovascularization and can be sight-threatening if not treated. It can be caused by things like an infection, traumatic injury, chemical injury, transplantation and autoimmune conditions to name a few. Neovascularization can even be caused by wearing your contact lenses for too long, especially at night. The goal of treatment is to diminish and hopefully stop this vascular growth.
Corneal neovascularization treatment options have expanded significantly over the past few years and can make the difference when it comes to saving your sight. Contact your ophthalmologist for more information on the treatments described below.
Non-Surgical Corneal Neovascularization Treatment Options
1. New Contact Lenses
Contact lenses can starve the eyes of oxygen. It’s call hypoxia and can result in neovascularization. For those that develop the condition, as a result of wearing contact lenses, effects can be reduced by going back to wearing glasses. At that point, your physician can plan a treatment program.
Usually, the strategy will focus on a combination of medications along with new contact lenses. Fortunately, today’s contact lenses have many higher levels of oxygen transmissibility which should resolve the problem. These allow your eyes to get the oxygen they need to prevent the condition from recurring.
2. Anti-inflammatory Drugs
Anti-inflammatory drugs in steroid and non-steroid topical form along with anti-inflammatory drugs are often seen as the first line of defense in the treatment of neovascularization. The anti-inflammatory drugs are used for their analgesic and antipyretic as well as to reduce inflammation.
However, this treatment also comes with side effects such as corneal melting and ulceration with the use of anti-inflammatory drugs and cataracts, glaucoma, herpes simplex and a higher risk of infection with the use of steroids.
3. Anti-vascular Endothelial Growth Factor Drugs
A newer treatment is the use of anti-vascular endothelial growth factor drugs such as ranibizumab, bevacizumab and pegatanib sodium. The combination of the orally administered drug plus the topical corticosteroids helps to suppress the vascular endothelial development factor that results in neovascularization.
These drugs have been used for different retinal diseases but were recently found to hinder the iso-form of vascular endothelial development factors. However, they also come with some limitations. They’re an experimental treatment and, although effective, must be repeated. Again, they are not a cure.
4. Corneal Neovascularization Treatments
Sometimes the cornea becomes inflamed because of neovascularization. Doctors are now utilizing corneal neovascularization treatment options that include the drug doxycycline and a topical corticosteroid. The thought is that the combination will resolve the condition by suppressing the enzymes that can obstruct and jeopardize corneal structural integrity. It’s still in the experimental phase, however, so far it is proving to be a highly effective alternative.
Surgical Corneal Neovascularization Treatment Options
It should be noted that non-surgical treatments are attempted prior to the implementation of surgical procedures. In cases where corneal neovasculaization can’t be resolved in any other way, surgery may be the only hope for many at retaining their eyesight over time.
5. Laser Ablation Treatments
Laser ablation treatments, such as with Argon and ND: YAG lasers, are used to coagulate blood capillaries and remove obstructions that invade tissues. Its success, however, depends on the rate of blood flow as well as depth and size of the obstruction. On the down side, the procedure can trigger an inflammatory response which can make the problem worse. The cornea may also thin over time or may hemorrhage.
6. Photodynamic Therapy
Photodynamic therapy is proving to be a highly effective option. It is where a light-activated dye is used to help seal up abnormal blood vessels. The dye is injected into the patient’s arm and accumulates in abnormal vessels in the eye. A non-thermal or “cold” laser is then directed at those vessels.
The laser activates the dye which breaks up clots and destroys the bad blood vessels while sparing the retina. It also creates tiny scars at the corner of the retina which inhibits the effect of growth factors. On the down side, it’s an extremely expensive procedure and can lead to lots of other complications especially in cases where the procedure has to be repeated. .
7. Diathemy and Cautery Treatments
The problem originates in the limbus so diathemy and cautery treatments have been used in place of lasers. In these procedures the feeder vessels in the limbus are cauterized with an electrolysis needle. The electronic pulse generated in the needle blocks the vessel using a unipolar diathemy system or thermal cautery.
8. Limbal Grafting
When chemical or thermal injuries are involved, limbal grafting is often required. This involves the transplantation of human amniotic membrane obtained from cesarean deliveries and cryo-frozen being sutured onto the ocular surface. It is a way to reduce inflammation, neovascularization and scarring which then allows doctors to successfully complete surface reconstruction.
The Future of Corneal Neovascularization Treatment Options
Studies are currently being conducted to determine the effectiveness of utilizing nanomedicine as a corneal neovascularization treatment option. The objective is to utilize nanoparticle-based molecules to enhance the permeability and pharmacological properties of the drugs currently in use.
With the use of nanomedicine, numerous metallic, polymeric and/or hybrid nanoparticles transport genes directly to the desired corneal cells in order to intercept pathologic pathways and processes that lead to blindness. In the case of corneal neovascularization, corneal avascularity prevents neovascularization along with inhibiting several other causal factors.
Recent studies suggest that nanotechnology will serve as a drug delivery system that can impact the condition on a molecular level. It is currently in animal trials but should progress at a rapid pace in the future since animal studies have proven so promising.
Sometimes people don’t realize how important their eyesight is until something goes wrong. Neovascularization is just one condition that can threaten your eyesight and, if left untreated, will result in blindness. Unfortunately, it can be caused by any number of reasons.
Seeking immediate help with determining what corneal neovascularization treatment options are available and which is the best for you will require close collaboration with your ophthalmologist. The sooner you seek help, the more likely the condition can be resolved.