, Volume 51, Issue 9, pp 1570-1573
Date: 08 Jul 2008

Is blockade of vascular endothelial growth factor beneficial for all types of diabetic retinopathy?

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The pathophysiology of diabetic retinopathy leads to the clinical findings of increased retinal vascular permeability and progressive retinal ischaemia, and vascular endothelial growth factor (VEGF) has been identified as a key mediator in diabetic retinopathy. Loss of vision is most commonly a direct or indirect sequela of VEGF-mediated pathology, with ischaemia and/or oedema, retinal neovascularisation, vitreous haemorrhage and traction retinal detachment. Laser photocoagulation has been the standard of care in the treatment of both diabetic macular oedema (DMO) and proliferative diabetic retinopathy (PDR), and has been documented as reducing visual loss [1, 2]. In the Early Treatment Diabetic Retinopathy Study (ETDRS), laser treatment for PDR reduced the incidence of severe vision loss by 50%, and laser treatment for DMO reduced the incidence of moderate visual loss by 50% [2]. Although benefits were statistically significant, visual gains were limited.

Thus, there is clearly a need ...