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Neovascularization, Corneal, CL-related Medication

  • Author: Barry A Weissman, OD, PhD, FAAO; Chief Editor: Hampton Roy, Sr, MD  more...
Updated: Aug 19, 2015

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.



Class Summary

Usually decrease inflammation that aggravates neovascularization.

Prednisolone ophthalmic (Omnipred, Pred Forte, Pred Mild)


Effective topical ophthalmic steroid use decreases the angiogenic effect during NV. The steroids decrease inflammation by reducing capillary permeability and cellular exudation, suppress lymphocytic proliferation, inhibit phospholipase A synthesis, and inhibit cell-mediated immune responses. Use of steroids is limited for short-term use only owing to the many side effects, including cataracts and glaucoma. Milder steroids such as loteprednol have lower risks of cataracts and glaucoma and are preferred over stronger steroids in these patients.

Loteprednol ophthalmic (Alrex, Lotemax)


Prevents inflammation by inhibiting capillary dilation, leukocyte formation, and edema. It is a mild corticosteroid with lower risks of developing cataracts and glaucoma and is preferred over stronger steroids in these patients.


Vascular Endothelial Growth Factor (VEGF) Inhibitors

Class Summary

Anti-VEGF antibodies bind and inactivate VEGF, which is an important mediator of angiogenesis that is upregulated during neovascularization. Anti-VEGF agents show promise in the treatment of severe corneal neovascularization though perhaps are excessive for contact lens–induced NV.

Bevacizumab (Avastin)


Monoclonal antibody that binds to and neutralizes vascular endothelial growth factor (VEGF). The binding of the monoclonal antibody to VEGF may inhibit the formation of new blood vessels, which may in turn reduce the growth of all tissues.

Ranibizumab (Lucentis)


Monoclonal antibody that binds to and neutralizes vascular endothelial growth factor A (VEGF-A). The binding of the monoclonal antibody to VEGF may inhibit the formation of new blood vessels, which may in turn reduce the growth of all tissues.

Contributor Information and Disclosures

Barry A Weissman, OD, PhD, FAAO Professor of Optometry, Southern California College of Optometry; Professor Emeritus of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Barry A Weissman, OD, PhD, FAAO is a member of the following medical societies: American Academy of Optometry, American Optometric Association, California Optometric Society, International Society for Contact Lens Research

Disclosure: Nothing to disclose.


Karen K Yeung, OD, FAAO Senior Optometrist, Arthur Ashe Student Health and Wellness Center, University of California, Los Angeles

Karen K Yeung, OD, FAAO is a member of the following medical societies: American Academy of Optometry

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Christopher J Rapuano, MD Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Director of the Cornea Service, Co-Director of Refractive Surgery Department, Wills Eye Hospital

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Ophthalmological Society, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, International Society of Refractive Surgery, Cornea Society, Eye Bank Association of America

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cornea Society, Allergan, Bausch & Lomb, Bio-Tissue, Shire, TearScience, TearLab<br/>Serve(d) as a speaker or a member of a speakers bureau for: Allergan, Bausch & Lomb, Bio-Tissue, TearScience.

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, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Andrew W Lawton, MD Neuro-Ophthalmology, Ochsner Health Services

Andrew W Lawton, MD is a member of the following medical societies: American Academy of Ophthalmology, Arkansas Medical Society, Southern Medical Association

Disclosure: Nothing to disclose.

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