Several signs or symptoms can be used to diagnose corneal neovascularization including corneal swelling due to capillary dilation and perforation, and recurrent corneal erosions. The presence of any of these signs may help to suspect the diagnosis. Treatment is directed at the underlying cause.
Fibrin adhesives, with the addition of dexamethasone, may be a successful adjunct therapy in the treatment of CNVM. Our patients with CNVM received more steroid medication than did the control cases, and the number of injections was not reported on in any case. Findings from a recent study obtained have proven the reliability and safety of these treatments, and should encourage surgeons to consider the use of fibrin glue as a primary therapy in eyes with CNVM.
Corneal neovascularization may occur because of a persistent systemic inflammatory disease or as a complication of ocular surgery. There seems to be an association between severe peri-operative inflammation and corneal neovascularization.
Although not tested in this research, a possible theory suggests a causal association of diabetes and retinopathy with CNV. If proven, this would be the first time diabetics have been found to be affected by a new vascular growth pattern. CNV is also known to be a complication of diabetes. Diabetics may be predisposed to developing CNVM, because of (1) the underlying cause and severity of their diabetes, (2) the long term effects of their untreated disease, and (3) the progressive damage done to the corneal endothelium during the course of the disease.
About 8.7 million people in the United States have a new diagnosis of corneal neovascularization each year, of which nearly 25% are unilateral neovascularization. Nearly half of people diagnosed with corneal neovascularization are women, compared with only 8% of the general population. Corneal neovascularization disproportionately affects young patients with diabetes.
Therapeutic modalities to corneal neovascularization are diverse and include topical medication, surgical excision, laser treatments, topical steroids, and radiation therapy. Topical medication is the first line management approach. Laser treatment offers a safer and more economical alternative for selected cases. Surgical excision yields significant results in cases of refractory ocular NV, but has to be reserved for cases not responsive to topical therapy. There are a number of cases where laser treatments alone yields effective ocular NV suppression when given as part of regular treatment regimen. The use of topical steroids as part of regular treatment may aid in the control of ocular NV. Radiation therapy has to a good degree of success in achieving suppression as part of regular treatment.
New studies that focus on corneal pathologies such as vascular disorders have been recently published and will be of great contribution for the future treatment of corneal neovascularization.
It seems likely that there are many more such trials that have been performed but not reporting their results. Our analysis may assist in this area. Data from a recent study of this analysis suggest that the lack of such reported trials may be because treatment has not proven statistically significantly effective.
Treatment for corneal neovascularization seems to be effective at improving quality of life and functioning overall, as well as eye symptoms. Quality of life with neovascular eyes is different than those with normal corneae. Neovascularization causes many ocular symptoms such as pain, tearing, photophobia, and blepharospasm, and patients must therefore carefully choose their treatment.
Patients with FED have a stronger probability to have CAD than controls. Moreover, in the CAD group, CAD is found for the first time at an earlier stage of FED than in patients without CAD. This suggests that CAD has a genetic component. There appears to be little or no relation between CAD and the FED severity index, i.e. the presence and the severity of FED at the time FED is diagnosed. Patients with diabetes do not seem to be at an increased mortality risk compared to non-diabetics.
Corneal Neovascularization in Fuchs-Krefft Dystrophy can often be treated with intravitreal injections of Avastin (bovine serum albumin). A randomized study is required to prove that this therapy is effective and safe in Fuchs-Krefft Dystrophic patients. But in order to treat neovascularization in all Fuchs-Krefft Dystrophic patients, a multimodal treatment should be performed; moreover, a correct follow-up should be done, especially in order to detect early signs of glaucoma, cataracts and/or retinal detachment.
Data from a recent study, younger patients (age < or = 50 years) had a higher risk of developing vascular endothelial growth factor (VEGF)-related corneal neovascularization. Corneal neovascularization was significantly associated with younger age and a history of prior corneal trauma.