Anti-vascular endothelial growth factor therapy for ocular neovascular disease.
OBJECTIVE
Recent research has shown that vascular endothelial growth factor (VEGF) is responsible for many ocular pathologies involving neovascularization. Over the past several years several new agents targeting VEGF have become commercially available for intraocular use. These agents have revolutionized the care of neovascular age related macular degeneration and have great potential for other blinding conditions such as diabetic retinopathy, retinopathy of prematurity, and neovascular glaucoma.


RESULTS
The VEGF Inhibition Study in Ocular Neovascularization (VISION) trial first showed that an anti-VEGF agent (pegaptanib) was able to prevent vision loss in neovascular age related macular degeneration. The Minimally Classic/Occult Trial of Anti-VEGF Antibody Ranibizumab in the Treatment of Neovascular AMD (MARINA) and Anti-VEGF Antibody for the Treatment of Predominantly Classic Choroidal Neovascularization in AMD (ANCHOR) trials showed that ranibizumab prevented moderate vision loss in neovascular age related macular degeneration and for the first time that a substantial proportion of patients regained vision. Smaller case series have shown that bevacizumab can regress retinal, iris and disc neovascularization. Ongoing trials are investigating the utility of anti-VEGF therapy in retinopathy of prematurity, diabetic retinopathy, and neovascular glaucoma.


CONCLUSIONS
Newer anti-VEGF therapies have shown unprecedented efficacy in treating age related macular degeneration with many patients experiencing improvement in vision. Ongoing trials will help guide their use in age related macular degeneration and expand their indications to many other blinding diseases.
Andreoli
Christopher M
CM
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts 02114, USA.
Miller
Joan W
JW
D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D001766:Blindness / Q000209:etiology; D020256:Choroidal Neovascularization / Q000188:drug therapy / Q000209:etiology; D003930:Diabetic Retinopathy / Q000150:complications; D005123:Eye / Q000098:blood supply*; D015355:Glaucoma, Neovascular / Q000188:drug therapy; D006801:Humans; D007231:Infant, Newborn; D008268:Macular Degeneration / Q000150:complications; D009389:Neovascularization, Pathologic / Q000150:complications / Q000188:drug therapy*; D015861:Retinal Neovascularization / Q000188:drug therapy / Q000209:etiology; D012178:Retinopathy of Prematurity / Q000150:complications; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A