title: Anti-VEGF for the management of diabetic macular edema.
abstract: Diabetic retinopathy (DR) is an important cause of vision loss around the world, being the leading cause in the population between 20 and 60 years old. Among patients with DR, diabetic macular edema (DME) is the most frequent cause of vision impairment and represents a significant public health issue. Macular photocoagulation has been the standard treatment for this condition reducing the risk of moderate visual loss by approximately 50%. The role of vascular endothelial growth factor (VEGF) in DR and DME pathogenesis has been demonstrated in recent studies. This review addresses and summarizes data from the clinical trials that investigated anti-VEGF for the management of DME and evaluates their impact on clinical practice. The literature searches were conducted between August and October 2013 in PubMed and Cochrane Library with no date restrictions and went through the most relevant studies on pegaptanib, ranibizumab, bevacizumab, and aflibercept for the management of DME. The efficacy and safety of intravitreal anti-VEGF as therapy for DME have recently been proved by various clinical trials providing significantly positive visual and anatomical results. Regarding clinical practice, those outcomes have placed intravitreal injection of anti-VEGF as an option that must be considered for the treatment of DME.
authors.affiliation: Retina Division, Retina Division, Department of Ophthalmology and Visual Sciences, Federal University of São Paulo (UNIFESP), 821 Botucatu Street, 2nd Floor, 04023-062 São Paulo, SP, Brazil ; Doheny Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Los Angeles, CA 900033, USA.
authors.forename: Francisco Rosa
authors.initials: FR
authors.lastname: Stefanini
authors.affiliation: Retina Division, Retina Division, Department of Ophthalmology and Visual Sciences, Federal University of São Paulo (UNIFESP), 821 Botucatu Street, 2nd Floor, 04023-062 São Paulo, SP, Brazil.
authors.forename: Emmerson
authors.initials: E
authors.lastname: Badaró
authors.affiliation: Retina Division, Retina Division, Department of Ophthalmology and Visual Sciences, Federal University of São Paulo (UNIFESP), 821 Botucatu Street, 2nd Floor, 04023-062 São Paulo, SP, Brazil ; Doheny Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Los Angeles, CA 900033, USA.
authors.forename: Paulo
authors.initials: P
authors.lastname: Falabella
authors.affiliation: Doheny Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Los Angeles, CA 900033, USA ; Department of Ophthalmology, Goethe University, 7 Theodor Stern Kai, 60590 Frankfurt am Main, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Koss
authors.affiliation: Retina Division, Retina Division, Department of Ophthalmology and Visual Sciences, Federal University of São Paulo (UNIFESP), 821 Botucatu Street, 2nd Floor, 04023-062 São Paulo, SP, Brazil.
authors.forename: Michel Eid
authors.initials: ME
authors.lastname: Farah
authors.affiliation: Retina Division, Retina Division, Department of Ophthalmology and Visual Sciences, Federal University of São Paulo (UNIFESP), 821 Botucatu Street, 2nd Floor, 04023-062 São Paulo, SP, Brazil ; Department of Ophthalmology, Goethe University, 7 Theodor Stern Kai, 60590 Frankfurt am Main, Germany.
authors.forename: Maurício
authors.initials: M
authors.lastname: Maia
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D052157:Aptamers, Nucleotide / Q000627:therapeutic use*; D000068258:Bevacizumab; D002986:Clinical Trials as Topic; D003930:Diabetic Retinopathy / Q000150:complications / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D015870:Gene Expression; D006801:Humans; D058449:Intravitreal Injections; D008028:Light Coagulation; D008269:Macular Edema / Q000150:complications / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D000069579:Ranibizumab; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors* / Q000235:genetics
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide; D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; C495058:pegaptanib; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab
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