関: corneal angiogenesis、corneal neovascularisation

WordNet

the transparent dome-shaped anterior portion of the outer covering of the eye; it covers the iris and pupil and is continuous with the sclera
of or related to the cornea

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/11/15 16:58:17」(JST)

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Corneal neovascularization is the excessive ingrowth of blood vessels from the limbal vascular plexus into the cornea, caused by deprivation of oxygen from the air.

Cause

One of the most common cause of corneal neovascularization is contact lens wear, especially those made with older hydrogel contact lens materials such as HEMA (2-hydroxyethyl methacrylate) for both daily and extended wear. Such older hydrogel materials have a relatively low oxygen transmissibility so the cornea ends up being starved of oxygen hence the response of the ingress of blood capillaries into the clear cornea to satisfy that oxygen demand. Also, there has been multiple causes proved to be involved with corneal neovascularization, including herpes simplex and corneal ulcers.^[1]

Pathogenesis

Chemical theory

There may be presence of vasostimulatory factor (VSF) or the breakdown (destruction) of previously existing vasoinhibitory factor (VIF).^[2]

Mechanical theory

Blood vessels cannot invade normal cornea because of its compactness and loosening of the compactness of corneal tissue due to oedema was mandatory for neovascularization.

Combined theory

Both release of some vasostimulatory factor (VSF) and structural loosening of compact corneal stroma by oedema are necessary for the neovascularization to occur.^[3]

Treatment

Modern rigid gas permeable and silicon hydrogel contact lenses have a much higher level of oxygen transmissibility, making them effective alternatives to help prevent corneal neovascularization.

Complications

In advanced stages, corneal neovascularization can threaten eyesight, which is why eye routine (annual) exams are recommended for contact lens patients.

Research

Reduction of neovascularization has been achieved in rats by the topical instillation of commercially available triamcinolone and doxycycline.^[4]

Some evidence exists to suggest that the Angiotensin II receptor blocker drug telmisartan will prevent corneal neovascularization.^[5]

Recent treatment developments include, topical application of bevacizumab, an anti-VEGF.^[6]

References

^ Abdelfattah, NS; Amgad, M; Zayed, AA; Salem, H; Elkhanany, AE; Hussein, H; Abd El-Baky, N (2015). "Clinical correlates of common corneal neovascular diseases: a literature review.". International journal of ophthalmology. 8 (1): 182–93. doi:10.3980/j.issn.2222-3959.2015.01.32. PMID 25709930.
^ Abdelfattah NS, Amgad M, Zayed AA, Hussein H, Abd El-Baky N. Molecular underpinnings of corneal angiogenesis: advances over the past decade. Int J Ophthalmol. 2016 May 18;9(5):768-79
^ Abdelfattah NS, Amgad M, Zayed AA. Host immune cellular reactions in corneal neovascularization. Int J Ophthalmol. 2016 Apr 18;9(4):625-33.
^ Riazi-Esfahani, M; Peyman, GA; Aydin, E; Kazi, AA; Kivilcim, M; Sanders, DR (August 2006). "Prevention of corneal neovascularization: evaluation of various commercially available compounds in an experimental rat model.". Cornea. 25 (7): 801–5. doi:10.1097/01.ico.0000220768.11778.60. PMID 17068457.
^ Usui, T.; Sugisaki, K.; Iriyama, A.; Yokoo, S.; Yamagami, S.; Nagai, N.; Ishida, S.; Amano, S. (2008). "Inhibition of Corneal Neovascularization by Blocking the Angiotensin II Type 1 Receptor". Investigative Ophthalmology & Visual Science. 49 (10): 4370–4376. doi:10.1167/iovs.07-0964. PMID 18829859.
^ Cheng, Sheng-Fu; Dastjerdi, Mohammad H.; Ferrari, Giulio; Okanobo, Andre; Bower, Kraig S.; Ryan, Denise S.; Amparo, Francisco; Stevenson, William; Hamrah, Pedram; Nallasamy, Nambi; Dana, Reza (December 2012). "Short-Term Topical Bevacizumab in the Treatment of Stable Corneal Neovascularization". American Journal of Ophthalmology. 154 (6): 940–948.e1. doi:10.1016/j.ajo.2012.06.007.

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UpToDate Contents

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1. コンタクトレンズの合併症 complications of contact lenses
2. 春季カタル vernal keratoconjunctivitis
3. アトピー性角結膜炎 atopic keratoconjunctivitis
4. 外傷性前房出血：臨床的特徴および診断 traumatic hyphema clinical features and diagnosis
5. コーガン症候群 cogans syndrome

English Journal

Anti-angiogenic effect of a humanized antibody blocking the Wnt/β-catenin signaling pathway.

Qiu F1, Shin Y2, Chen D3, Cheng R4, Chen Q5, Zhou K6, Larrick JW7, Mendelson AR7, Ma JX8.
Microvascular research.Microvasc Res.2018 Sep;119:29-37. doi: 10.1016/j.mvr.2018.03.011. Epub 2018 Apr 7.
PMID 29630973

Xanthatin inhibits corneal neovascularization by inhibiting the VEGFR2‑mediated STAT3/PI3K/Akt signaling pathway.

Shen M1, Zhou XZ2, Ye L3, Yuan Q3, Shi C4, Zhu PW3, Jiang N3, Ma MY3, Yang QC5, Shao Y3.
International journal of molecular medicine.Int J Mol Med.2018 Aug;42(2):769-778. doi: 10.3892/ijmm.2018.3646. Epub 2018 Apr 30.
PMID 29717775

Herpetic eye disease study: lessons learned.

Kalezic T1, Mazen M2, Kuklinski E2, Asbell P2.
Current opinion in ophthalmology.Curr Opin Ophthalmol.2018 Jul;29(4):340-346. doi: 10.1097/ICU.0000000000000482.
PMID 29846207

Japanese Journal

Deterioration of Glaucoma After Carotid Endarterectomy:—Case Report—

KATSUTA Toshiro,FUJIMOTO Akiko,OBA Kumiyo
Neurologia medico-chirurgica 53(6), 418-421, 2013
… Right intraocular pressure was markedly increased, and corneal edema and increased iris neovascularization were also recognized. … Ocular ischemia causes not only neovascularization of the iris, which leads to insufficient resorption of the aqueous humor, but also insufficient production of the aqueous humor. …
NAID 130003364259