J Korean Med Assoc.  2016 Jan;59(1):52-57. 10.5124/jkma.2016.59.1.52.

Intravitreal injection of anti-vascular endothelial growth factor for patients with various retinal diseases

Affiliations
  • 1Department of Ophthalmology, The Catholic University of Korea College of Medicine, Seoul, Korea. john0730@catholic.ac.kr
  • 2Department of Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 3Clinical Research Institute, Daejeon St. Mary's Hospital, Daejeon, Korea.

Abstract

Vascular endothelial growth factor (VEGF-A) is a major regulator of angiogenesis and vascular permeability. VEGF-A plays an important role in a wide variety of retinal diseases. Therefore, intravitreal injection of anti-VEGF agents is increasingly used for the treatment of various vasoproliferative or exudative retinal diseases. There are several anti-VEGF drugs available that are currently used, but three are most commonly used in practice. They are ranibizumab, bevacizumab, and aflibercept. Ranibizumab is a humanized monoclonal antibody fragment targeting VEGF-A, but bevacizumab, commonly used off-label, is a humanized full-length anti-VEGF antibody. Aflibercept is a recombinant fusion protein consisting of portions of human VEGF receptors 1 and 2 extracellular domains fused to the Fc portion of human IgG1. These anti-VEGF therapies have resulted in unprecedented visual and anatomic outcomes, especially in patients with neovascular age-related macular degeneration (AMD) and diabetic macular edema (DME). Visual stabilization or clinically significant visual improvement can be expected if intravitreal injections of anti-VEGF agents are properly provided for patients with neovascular AMD or DME in the course of the disease. Treating retinal diseases with intravitreal injection of anti-VEGF agents may have potential side effects. Systemic adverse effects attributable to VEGF inhibition may cause thromboembolic events. Acute endophthalmitis is the most feared injection-related ocular side effect. The development of anti-VEGF agents for various retinal diseases provides a safe and effective treatment. There is no doubt that further advances in anti-VEGF therapy can be expected soon.

Keyword

Intravitreal injections; Vascular endothelial growth factor; Ranibizumab; Bevacizumab; Aflibercept

MeSH Terms

Bevacizumab
Capillary Permeability
Endophthalmitis
Endothelial Growth Factors*
Humans
Immunoglobulin G
Intravitreal Injections*
Macular Degeneration
Macular Edema
Ranibizumab
Receptors, Vascular Endothelial Growth Factor
Retinal Diseases*
Retinaldehyde*
Vascular Endothelial Growth Factor A
Endothelial Growth Factors
Immunoglobulin G
Receptors, Vascular Endothelial Growth Factor
Retinaldehyde
Vascular Endothelial Growth Factor A

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