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Anti-VEGF Strategies in Ocular Angiogenesis-mediated Disorders, with Special Emphasis on Age-related Macular Degeneration

  • Shaker A. Mousa
Chapter

Abstract

Pathological angiogenesis in the eye including exudative age-related macular degeneration (AMD), proliferative diabetic retinopathy, diabetic macular edema, neovascular glaucoma, and corneal neovascularization (trachoma) underlies the major causes of blindness in both developed and developing nations. Additionally, increased rates of angiogenesis are associated with several other disease states including cancer, psoriasis, rheumatoid arthritis and other vascular-associated disorders. Vascular endothelial growth factor (VEGF) and its receptors play an important role in the modulation of angiogenesis and have been implicated in the pathology of a number of conditions, including AMD, diabetic retinopathy, and cancer. AMD is a progressive disease of the macula and the third major cause of blindness worldwide. If not treated appropriately, AMD might progress to the second eye. Until recently, the treatment options for AMD were limited, with photodynamic therapy the mainstay treatment, which is effective at slowing disease progression but rarely results in improved vision. There are currently three approved anti-angiogenesis biologic therapies for ophthalmic diseases: an anti-VEGF aptamer (pegaptanib, Macugen®), a Fab fragment of a monoclonal antibody directed against VEGF-A (ranibizumab, Lucentis®), and VEGF trap (aflibercept, Eylea®). Several therapies have been and are now being developed for neovascular AMD, with the goal of inhibiting VEGF. At present, established therapies have met with great success in reducing the vision loss associated with neovascular AMD, whereas those still investigational in nature offer the potential for further advances. In AMD patients these therapies slow the rate of vision loss and in some cases increase visual acuity. Although these therapies are a milestone in the treatment of these disease states, several concerns need to be addressed before their impact can be fully understood.

Keywords

Vascular Endothelial Growth Factor Vascular Endothelial Growth Factor Receptor Diabetic Macular Edema Intravitreal Bevacizumab Vascular Endothelial Growth Factor Inhibitor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.The Pharmaceutical Research Institute at Albany College of Pharmacy and Health SciencesRensselaerUSA

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