[Intravitreal drug therapy for retinal vein occlusion--pathophysiological mechanisms and routinely used drugs].
The novel therapeutic principle of intravitreal drug therapy for retinal vein occlusion has become an integrated constituent of clinical practice over the last years. The two substance classes that have been evaluated in large randomised clinical trials so far are corticosteroids and inhibitors of vascular endothelial growth factor (VEGF). The reported treatment success of these intravitreally administered substances has lead not only to a paradigm shift in clinical care but has also advanced our understanding of the underlying pathophysiological principles of retinal vein occlusions. In this review the different substances are discussed, their mechanisms of action are analysed and the results of the large clinical trials available to date are critically evaluated. Furthermore, an approach to integrate these novel treatment options into the existing treatment regimes for retinal vein occlusions is suggested.
Feltgen
N
N
Universitäts-Augenklinik Göttingen. nicolas.feltgen@med.unigoettingen.de
Pielen
A
A
Hansen
L
L
Bertram
B
B
Agostini
H
H
Jaissle
G B
GB
Hoerauf
H
H
Stahl
A
A
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide / Q000008:administration & dosage / Q000009:adverse effects; D000068258:Bevacizumab; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D002455:Cell Division / Q000187:drug effects / Q000502:physiology; D003131:Combined Modality Therapy; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D004921:Erythropoietin / Q000378:metabolism; D006438:Hemodilution; D006801:Humans; D058449:Intravitreal Injections; D017075:Laser Coagulation; D008134:Long-Term Care; D010211:Papilledema / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D000069579:Ranibizumab; D012161:Retinal Artery / Q000187:drug effects / Q000503:physiopathology; D012169:Retinal Vein / Q000187:drug effects / Q000503:physiopathology; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors* / Q000502:physiology
D000305:Adrenal Cortex Hormones; D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D004921:Erythropoietin; C495058:pegaptanib; D000068258:Bevacizumab; D003907:Dexamethasone; D014222:Triamcinolone Acetonide; D000069579:Ranibizumab