Propranolol eye drops in patients with corneal neovascularization

Rationale: Studies performed in animal models of corneal neovascularization suggested the possible efficacy of a treatment with propranolol. Corneal neovascularization is one of the most feared complications of Stevens–Johnson syndrome that frequently involves ocular surface. We report the first 2 patients with severe ocular neo-vascularization treated with different degrees of success, with propranolol eye drops. Patient concerns: Two patients with corneal neovascularization complicating the Stevens–Johnson syndrome, not responsive to steroids and cyclosporine, were treated with propranolol eye drops. Diagnoses: Corneal neovascularization was detected by ophthalmoscopic evaluation. Interventions: Topical treatment with propranolol eye drops at different concentrations. Outcomes: Both patients reported dramatic subjective benefits (reduction of photophobia and discomfort) without adverse effects, and in the patient with a less advanced disease, an objective reduction of neovascularization and an improved visual acuity was observed. Lessons: This experience suggests that propranolol might be an inexpensive, safe and effective treatment in counteracting the progression of corneal neovascularization.