Subconjunctival injection of anti-VEGF agent bevacizumab as treatment in patients with dry eye disease

To assess the effect of subconjunctival injection of anti-VEGF bevacizumab in the management of dry eye disease in a tertiary care hospital. In this quasi-experimental trial 150 eyes of 75 patients were selected using non-probability consecutive sampling technique. Detailed clinical examination was performed, the ocular surface disease index (OSDI) questionnaire score, tear film break-up time (TBUT) and Schirmer test 2 were measured and compared pre and post injection. Six patients were excluded and sixty-six patients were included having the mean age was 65.3 (SD=±10.2) years, 50% were aged 66-83 years old, 65.2% were female. Pre injection OSDI score was 30.3 (SD=±2.79), whereas post injection it was 20.2 (SD=±3.01). Pre injection TBUT was 3.0 (SD=±0.30), whereas post injection it was 5.17 (SD=±0.40). Pre injection Schirmer 2 test was 7.97 (SD=±0.51), whereas post injection it was 10.5 (SD=±0.50). Ten patients suffered mild subconjunctival hemorrhage which resolved spontaneously. Three patients were lost to follow up. Subconjunctival injection of anti-VEGF agent bevacizumab can offer a modern and safe solution in patients suffering from dry eye disease nevertheless more trials with large number of patients and longer follow up durations are required for widespread adaptation.