Unveiling Bevacizumab's Hidden Powers in the Management of Primary Pterygium

Background- Pterygium is one of the common ocular diseases, characterized by the triangular growth of fibrovascular conjunctival tissue starting from bulbar conjunctiva towards the cornea. Studies have shown the role of Vascular endothelial growth factor (VEGF) in the pathogenesis of pterygium, so we can presume that anti-VEGF drugs may be useful for pterygium patients. Objective : Off label use of bevacizumab in the management of pterygium. Study Design: Prospective Study. Methodology: This prospective study included twenty (40) eyes with primary pterygium and the effect of single dose of Bevacizumab (0.05 ml,1.25 mg) injected via subconjunctival route. The vascularity, thickness and size (in cm2) was recorded at baseline and 12 weeks after injection. Change in size, vascularity and thickness were the major outcomes, which were noted. Result: Overall there were 32 females (80%) and 08 males (20%), with an average age of 41.5 yrs. No significant difference in the mean surface area of pterygium during the follow up was seen. However, significant difference in the vascularity and thickness was noted. At baseline, there were 28 (70%) grade 2 and 12 (30%) grade 3 pterygium. At 12 weeks post injection, there were 14(35%) with grade 1 pterygium, 20(50%) with grade 2 & 6 (15%) with grade 3 pterygium. There was no serious ocular or systemic side effect noted during the course of the study. Conclusion: Subconjunctival injection of bevacizumab is very effective in decreasing the thickness and vascularity.