eMedicine Specialties > Ophthalmology > Cornea

Neovascularization, Corneal, CL-related: Differential Diagnoses & Workup

Author: Barry A Weissman, OD, PhD, FAAO, Chief of Contact Lens Service, Professor, Department of Ophthalmology, Jules Stein Eye Institute, University of California at Los Angeles
Coauthor(s): Karen K Yeung, OD, FAAO, Director of Optometry, Arthur Ashe Student Health and Wellness Center, University of California at Los Angeles
Contributor Information and Disclosures

Updated: Apr 10, 2009

Differential Diagnoses

Contact Lens Complications
Keratitis, Interstitial
Herpes Simplex
Onchocerciasis
Herpes Zoster
Squamous Cell Carcinoma, Conjunctival
Keratitis, Herpes Simplex
Tuberculosis

Other Problems to Be Considered

Trauma and other diseases that cause interstitial keratitis (eg, ocular herpes simplex and zoster virus infections, measles, tuberculosis, syphilitic keratitis, onchocerciasis)

Workup

Laboratory Studies

  • For systemic medical reasons, it is important to obtain a thorough case history of CL wear and to exclude other potential causes of corneal NV, especially if NV is seen deep in the corneal stroma. Pay attention to causes of interstitial keratitis such as herpes keratitis, tuberculosis, measles, and syphilis.
    • Herpes cultures if herpes is suspected and the diagnosis cannot be made on clinical examination
    • Tuberculosis (TB) skin test if TB is suspected
    • Rapid plasma reagin (RPR) and microhemagglutination-Treponema pallidum (MHA-TP) if syphilis is suspected

More on Neovascularization, Corneal, CL-related

Overview: Neovascularization, Corneal, CL-related
Differential Diagnoses & Workup: Neovascularization, Corneal, CL-related
Treatment & Medication: Neovascularization, Corneal, CL-related
Follow-up: Neovascularization, Corneal, CL-related
References

References

  1. Dixon JM. Corneal vascularization due to corneal contact lenses: the clinical picture. Trans Am Ophthalmol Soc. 1967;65:333-40. [Medline].

  2. Dixon JM, Lawaczec E. Corneal vascularization due to contact lenses. Arch Ophthalmol. 1963;69:106-9.

  3. Chan WK, Weissman BA. Corneal pannus associated with contact lens wear. Am J Ophthalmol. May 1996;121(5):540-6. [Medline].

  4. Cogan DG. Vascularization of the cornea. Its experimental induction by small lesions and a new theory of its pathogenesis. Arch Ophthalmol. 1949;41:406-416.

  5. Cogan DG. Corneal vascularization. Investigative Ophthalmology and Vis. 1962;(1): 2:253-61.

  6. Ashton N, Cook C. Mechanisms of corneal neovascularization. Brit J Ophthal. 1953;37:193-209.

  7. Madigan MC, Penfold PL, Holden BA, Billson FA. Ultrastructural features of contact lens-induced deep corneal neovascularization and associated stromal leukocytes. Cornea. Apr 1990;9(2):144-51. [Medline].

  8. Groden LR, Cassel GH, Laibson PR. The effect of corneal trephination on neovascularization. Ophthalmic Surg. Nov 1983;14(11):954-6. [Medline].

  9. Imre G. The role of increased lactic acid concentration in neovascularizations. Acta Morphol Hung. 1984;32(2):97-103. [Medline].

  10. Fromer CH, Klintworth GK. An evaluation of the role of leukocytes in the pathogenesis of experimentally induced corneal vascularization. Am J Pathol. Jun 1975;79(3):537-54. [Medline].

  11. Fromer CH, Klintworth GK. An evaluation of the role of leukocytes in the pathogenesis of experimentally induced corneal vascularization. III. Studies related to the vasoproliferative capability of polymorphonuclear leukocytes and lymphocytes. Am J Pathol. Jan 1976;82(1):157-70. [Medline].

  12. Koch AE, Polverini PJ, Leibovich SJ. Induction of neovascularization by activated human monocytes. J Leukoc Biol. Feb 1986;39(2):233-8. [Medline].

  13. Klintworth GK. Corneal Angiogenesis. New York: Springer-Verlag; 1991:1-30.

  14. Forister J, Forister EF, Yeung KK, Chung MY, Ye P, Tsai A, et al. Weissman BA. Prevalence of common ocular complications associated with contact lens wear: The UCLA contact lens complication study. Vis Opt Sci (In preparation).

  15. Donnenfeld ED, Ingraham H, Perry HD, Imundo M, Goldberg LP. Contact lens-related deep stromal intracorneal hemorrhage. Ophthalmology. Dec 1991;98(12):1793-6. [Medline].

  16. Filipec M, Hycl J, Kraus H. [Does vascularization and the graft diameter affect the rejection reaction in corneal transplantation?]. Cesk Oftalmol. Feb 1994;50(1):13-7. [Medline].

  17. Foulks GN, Steffanson E, Hamilton RC. Regression of corneal vascularization during silicone contact lens wear and the relationship to contact lens-induced anterior chamber hypoxia. Cornea. 1987;65:6-60.

  18. Qian CX, Bahar I, Levinger E, Rootman D. Combined use of superficial keratectomy and subconjunctival bevacizumab injection for corneal neovascularization. Cornea. Oct 2008;27(9):1090-2. [Medline].

  19. Benelli U, Bocci G, Danesi R, Lepri A, Bernardini N, Bianchi F. The heparan sulfate suleparoide inhibits rat corneal angiogenesis and in vitro neovascularization. Exp Eye Res. Aug 1998;67(2):133-42. [Medline].

  20. Crum R, Szabo S, Folkman J. A new class of steroids inhibits angiogenesis in the presence of heparin or a heparin fragment. Science. Dec 20 1985;230(4732):1375-8. [Medline].

  21. Lipman RM, Epstein RJ, Hendricks RL. Suppression of corneal neovascularization with cyclosporine. Arch Ophthalmol. Mar 1992;110(3):405-7. [Medline].

  22. D'Amato RJ, Loughnan MS, Flynn E, Folkman J. Thalidomide is an inhibitor of angiogenesis. Proc Natl Acad Sci U S A. Apr 26 1994;91(9):4082-5. [Medline].

  23. Bian F, Zhang MC, Zhu Y. Inhibitory effect of curcumin on corneal neovascularization in vitro and in vivo. Ophthalmologica. 2008;222(3):178-86. [Medline].

  24. Wong AL, Weissman BA, Mondino BJ. Bilateral corneal neovascularization and opacification associated with unmonitored contact lens wear. Am J Ophthalmol. Nov 2003;136(5):957-8. [Medline].

  25. Maguire MB. Risk factors for corneal graft failure and rejection in the collaborative corneal transplantation studies. Opthal. 1974;101:1536-1547.

  26. Sawa M, Awazu K, Takahashi T, et al. Application of femtosecond ultrashort pulse laser to photodynamic therapy mediated by indocyanine green. Br J Ophthalmol. Jun 2004;88(6):826-31. [Medline].

  27. Holzer MP, Solomon KD, Vroman DT, et al. Photodynamic therapy with verteporfin in a rabbit model of corneal neovascularization. Invest Ophthalmol Vis Sci. Jul 2003;44(7):2954-8. [Medline].

  28. Caffery BE, Josephson JE. Corneal vascularization. Optom Clin. 1995;4(3):19-29. [Medline].

  29. Grohe RM, Lebow KA. Vascularized limbal keratitis. Int Contact Lens Clinics. 1989;16:197-209.

  30. Jouseen AM, Druse FE, Volcker HE, et al. Topical application of methotrexate for inhibition of corneal angiogenesis. Graefes Arch Clin Exp Ophthalmol. 1999;238:920-7.

  31. Verbey NL, van Haeringen NJ, de Jong PT. Modulation of immunogenic keratitis in rabbits by topical administration of inhibitors of liposygenase and cyclooxygenase. Curr Eye Res. 1998;7:361-8.

Further Reading

Keywords

cornea, contact lens, neovascularization, corneal trauma

Contributor Information and Disclosures

Author

Barry A Weissman, OD, PhD, FAAO, Chief of Contact Lens Service, Professor, Department of Ophthalmology, Jules Stein Eye Institute, University of California at Los Angeles
Barry A Weissman, OD, PhD, FAAO is a member of the following medical societies: American Academy of Optometry, American Optometric Association, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Coauthor(s)

Karen K Yeung, OD, FAAO, Director of Optometry, Arthur Ashe Student Health and Wellness Center, University of California at Los Angeles
Karen K Yeung, OD, FAAO is a member of the following medical societies: American Academy of Optometry
Disclosure: Nothing to disclose.

Medical Editor

Andrew W Lawton, MD, Medical Director of Neuro-Ophthalmology Service, Section of Ophthalmology, Baptist Eye Center, Baptist Health Medical Center
Andrew W Lawton, MD is a member of the following medical societies: American Academy of Ophthalmology, Arkansas Medical Society, and Southern Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Institute
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery, and Pan-American Association of Ophthalmology
Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other; Vistakon Honoraria Speaking and teaching

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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