Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
John Cavenagh, MBA, PhD, PA-C
Objective: The objective of this selective EBM review is to determine whether or not Bevacizumab is an effective treatment in inhibiting the growth of recurrent pterygium.
Study Design: Review of three published, English language randomized controlled trials published in 2010, 2012, and 2013.
Data Sources: Three randomized controlled trials measuring the efficacy of Bevacizumab to inhibit the growth of recurrent pterygium were found using PubMed and OVID databases.
Outcome(s) Measured: The severity and progression of pterygium recurrence as well as corneal neovascularization were the main outcomes measured. Conjunctival injection, thickness, and size of the fibrovascular tissue were examined in subjects using ophthalmic evaluation including visual acuity testing, applanation tonometry, lit-lamp biomicroscopic examination, slit-lamp photography, indirect ophthalmoscopy, and corneal photographs.
Results: In the study by Fallah, all groups failed, meaning fibrovascular tissue stretched onto the cornea. However, the mean duration for invasion of cornea in study group patients was significantly longer than for control group patients. The study by Lekhanont showed that Bevacizumab significantly transiently decreased the conjunctival injection. However, true recurrence was found in 62 of 80 patients with no statistically significant difference among the groups. In the study by Ozgurhan, pterygium recurrence was not noted in any patients in the study group, but was noted in 2 of 22 eyes in the control group. Moreover, corneal neovascularization was noted in 5 of 22 eyes in the control group but in none of the patients of the study group.
Conclusion: The results of two of the randomized trials showed that Bevacizumab delays the recurrence of impending recurrent pterygium, but does not completely inhibit it. One of the randomized trials showed that Bevacizumab was an effective therapy for reducing recurrent pterygium and corneal neovascularization, but results were not statistically significant. Overall consistency was not provided and the data was inconclusive. All trials were limited due to small sample size and lack of follow-up studies.
De la Cruz, Sharon L., "Is Bevacizumab Effective in Inhibiting the Growth of Recurrent Pterygium?" (2015). PCOM Physician Assistant Studies Student Scholarship. 216.