Antivascular endothelial growth factor therapy for neovascular age-related macular degeneration.
OBJECTIVE
The most important recent advance in the treatment of neovascular age-related macular degeneration (AMD) is the development of antivascular endothelial growth factor (anti-VEGF) therapeutic agents that preserve and improve visual acuity by arresting choroidal neovascular growth and reducing vascular permeability. This review describes the current literature on the use of this therapeutic approach in the management of neovascular AMD.


RESULTS
Two anti-VEGF agents, pegaptanib sodium and ranibizumab, are currently approved by the United States Food and Drug Administration for the treatment of neovascular AMD. In addition, off-label use of a third anti-VEGF agent, bevacizumab, as a treatment option for neovascular AMD has become common worldwide. Other anti-VEGF agent strategies that have shown efficacy include small interfering RNA agents to silence the VEGF gene and receptor and the fusion protein VEGF trap.


CONCLUSIONS
The accumulation of preclinical and clinical evidence implicating VEGF-A in the pathogenesis of neovascular AMD has provided a strong rationale for the development of anti-VEGF agents for this disease. Anti-VEGF therapies have been used successfully in the clinic, encouraging their use in the treatment of other neovascular eye diseases.
Vitreoretinal Service, Midwest Eye Institute, Indianapolis, Indiana 46280, USA. thomasciulla@yahoo.com
Thomas A
TA
Ciulla
Philip J
PJ
Rosenfeld
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide / Q000627:therapeutic use; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D017277:Drug Approval; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy*; D000069579:Ranibizumab; D014481:United States; D014486:United States Food and Drug Administration; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide; D042461:Vascular Endothelial Growth Factor A; C495058:pegaptanib; D000068258:Bevacizumab; D000069579:Ranibizumab