Anti-Angiogenic Therapy for Retinal Diseases

Ocular angiogenesis is a major cause of disease and permanent blindness. The introduction of anti-vascular endothelial growth factor (anti-VEGF) agents has revolutionized the treatment of retinal vasogenic conditions. These drugs are now commonly employed for the treatment of a group of ocular pathologies, including exudative macular degeneration, diabetic macular edema, and retinal vein occlusion.

The most common anti-VEGF therapies for retinal diseases are bevacizumab (Avastin®), ranibizumab (Lucentis®) and aflibercept (Eylea®).

Multicenter, randomized, controlled clinical trials have been designed to study the efficacy of anti-VEGF therapy in common retinal angiogenic diseases. However, when it comes to extremely rare or uncommon retinal diseases, we must often rely on case studies or small series to elucidate a potential beneficial effect of anti-VEGF treatment. Continued experience with the use of anti-VEGF pharmacotherapy may offer additional treatment modalities for these conditions that have limited therapeutic options, and may also provide insight into their molecular pathophysiology.

In this chapter, we will describe the role of angiogenesis in retinal diseases, antiangiogenic therapies that are available at the moment, evidence based on clinical trials and new researches on ocular anti-VEGF therapy.

Keywords: Antiangiogenesis, Vasculogenesis, Vascular endothelial growth factor (VEGF), Ischemia, Anti-VEGF therapy, Anti-platelet-derived growth factor (anti- PDGF), Bevacizumab, Ranibizumab, Aflibercept, Retinal disease, Clinical trials.