Anti-VEGF for the management of diabetic macular edema

J Immunol Res. 2014;2014:632307. doi: 10.1155/2014/632307. Epub 2014 Feb 5.


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Aptamers, Nucleotide / therapeutic use*
  • Bevacizumab
  • Clinical Trials as Topic
  • Diabetic Retinopathy / complications
  • Diabetic Retinopathy / immunology
  • Diabetic Retinopathy / pathology
  • Diabetic Retinopathy / therapy*
  • Gene Expression
  • Humans
  • Intravitreal Injections
  • Light Coagulation
  • Macular Edema / complications
  • Macular Edema / immunology
  • Macular Edema / pathology
  • Macular Edema / therapy*
  • Ranibizumab
  • Receptors, Vascular Endothelial Growth Factor / therapeutic use*
  • Recombinant Fusion Proteins / therapeutic use*
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Vascular Endothelial Growth Factor A / genetics


  • Antibodies, Monoclonal, Humanized
  • Aptamers, Nucleotide
  • Recombinant Fusion Proteins
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • aflibercept
  • pegaptanib
  • Bevacizumab
  • Receptors, Vascular Endothelial Growth Factor
  • Ranibizumab