A topical eye drop versus intra-meibomian gland injection of bevacizumab for meibomian gland dysfunction patients.
Purpose: To compare the efficacy and safety of topical bevacizumab eye drop versus intra-meibomian gland injection of bevacizumab when used with the standard lid hygiene in meibomian gland dysfunction (MGD) patients. Methods: 60 eyes of 30 MGD patients with lid margin telangiectasia were randomized to receive 0.05% bevacizumab eye drop or single 2.5% intra-meibomian gland bevacizumab injection plus standard lid hygiene. The primary outcomes were telangiectasia grading and the computerized lid margin neovascularized area (LMNA). The secondary outcomes were the ocular surface disease index (OSDI) score, corneal staining, meibomian gland quality, meiboscore, conjunctival redness, fluorescein break up time (FBUT), noninvasive tear breakup time (NIBUT), lipid layer thickness (LLT), compliance of treatments, and adverse events (AE). All the parameters were re-evaluated before and until 3 months after treatment. Results: A significant improvement in telangiectasia grading and LMNA, primary outcomes, were observed in injection group at month 3 (p<0.05) but LMNA was not apparent in the eye drop group. In the injection group, there were significant improvements in corneal staining, meiboscore, and FBUT compared with the eye drop group (p<0.05). Both groups showed significant improvements in OSDI score, corneal staining, MG quality, meiboscore, and conjunctival redness compared with pre-treatment. (p<0.05). Conclusions: Both routes of intra-MG injection and eye drop bevacizumab administrations were safe and effective in reducing lid margin telangiectasia and signs and symptoms of MGD. Therefore, both routes of administration could be an alternative or adjunctive treatment with the standard lid hygiene for MGD patients.