Effect of Anti-Vascular Endothelial Growth Factor Therapy on Corneal Nerves

Raquel Goldhardt, Hatim Ismail M. Batawi, Mark Rosenblatt, Ivonne V. Lollett, Jasmine J. Park, Anat Galor

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Purpose: Vascular endothelial growth factor (VEGF) is a trophic factor for corneal nerves (CNs). Despite its widespread use to treat a variety of retinal diseases, the effect of repetitive intravitreal (IV) anti-VEGF injections on CN is not known. Methods: Retrospective case-control study. CN parameters were compared between eyes in 39 individuals who received anti-VEGF injections in one eye only. Next, we compared CN parameters between 50 eyes of 50 individuals with a history of IV anti-VEGF injections and 80 eyes of 80 individuals without a history of injection. In vivo confocal microscopic examination was conducted using the ConfoScan 4. Images were analyzed by the Corneal Nerve Analysis tool. Paired and independent t test methodologies were used to compare nerve parameters, and multivariable linear regression analysis was performed to control for potential confounders. Results: In 39 patients (own controls), eyes with a history of IV injection had lower CN length density, total length, nerve fibers, bifurcations, and branches (P < 0.005) compared to the fellow eyes without injection. Similar findings were seen in the eyes of 50 individuals with a history of injection compared to 80 individuals without injection. A history of IV injections and ethnicity remained significantly associated with the CN length density and explained 32% of the variability (R = 0.56). Conclusions: We found decreased CN parameters in eyes with a history of anti-VEGF injections compared to eyes without such a history.

Original languageEnglish (US)
Pages (from-to)559-564
Number of pages6
Issue number5
StatePublished - May 1 2019


  • aflibercept
  • anti-VEGF injections
  • bevacizumab
  • corneal nerves
  • vascular endothelial growth factor

ASJC Scopus subject areas

  • Ophthalmology


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