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2018 ; 2018
(ä): 2602487
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Simultaneous Subconjunctival Triamcinolone and Bevacizumab Injections for
Management of Blepharokeratoconjunctivitis in Children
#MMPMID29967706
Nguyen CL
; Chen TS
; Tran K
; Smith JEH
; Lewis N
Case Rep Ophthalmol Med
2018[]; 2018
(ä): 2602487
PMID29967706
show ga
PURPOSE: To report the efficacy of subconjunctival triamcinolone (Kenalog A-40,
Alcon) and bevacizumab (Avastin, Genentech) injections in fraternal twins with
blepharokeratoconjunctivitis (BKC) causing progressive, bilateral corneal
neovascularization and scarring. METHODS: In this retrospective observational
case series, two three-year-old male twins with BKC had presented with bilateral
red eyes, photophobia, and frequent blinking. Examination of each child showed
bilateral deep stromal and superficial corneal neovascularization, corneal
infiltrates, multiple follicles on the palpebral conjunctiva bilaterally with
blepharitis, and thick turbid sebum expressed from the Meibomian glands. Their
disease progressed despite conventional treatment. Both twins were managed with
subconjunctival triamcinolone injection and subconjunctival bevacizumab injection
of each eye. RESULTS: The treatment resulted in improvement of symptoms, and
examination over an 8-10-month period postinjections showed fading stromal
corneal infiltrates, partially regressed corneal neovascularization, and reduced
conjunctival injection without complications. CONCLUSION: This case series
highlights the potential vision threatening complications of BKC. In addition to
conventional management options, this report is the first published use of
subconjunctival triamcinolone and bevacizumab injections for BKC in children in
an attempt to minimize and improve corneal neovascularization and scarring and
subsequently to retain useful vision.