Changing paradigms of anti-VEGF in the Indian scenario.
Anti-vascular endothelial growth factors (VEGF) agents have revolutionized the treatment of retinal diseases. Use of anti-VEGF agents in the Indian Scenario present some unique challenges considering the absence of compounding pharmacies, poor penetrance of health insurance and limited affordability of the citizens of a developing economy. To study the changing paradigms of anti-VEGF use in the Indian scenario, all articles published by Indian authors, data from web-based surveys amongst Indian vitreo-retinal specialists were reviewed. In the paucity of compounding pharmacies in India, fractionation and injection techniques differ from those of developed countries. Frequent anti-VEGF monotherapy offers the best anatomical and visual results, but economics of scale do not allow the same in the Indian scenario, resulting in PRN dosing and combination of anti-VEGF with laser photocoagulation, being the commonly employed treatment protocols.
Vitre o-retinal and Ocular Oncology Services, Sankara Eye Hospitals, Bangalore, India.
P Mahesh
PM
Shanmugam
D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D006801:Humans; D007194:India / Q000453:epidemiology; D058449:Intravitreal Injections; D009017:Morbidity; D012164:Retinal Diseases / Q000188:drug therapy* / Q000453:epidemiology*; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A