[Prospects and Challenges of Anti-VEGF Drug Treatment for Pathological Angiogenesis of the Retina]

Yakugaku Zasshi. 2021;141(12):1307-1317. doi: 10.1248/yakushi.21-00158-1.
[Article in Japanese]

Abstract

The number of patients with exudative age-related macular degeneration, diabetic retinopathy and retinal vein occlusion is expected to rise in proportion with the aging of the population and increasing diabetes patients. Also, they are the most common diseases caused by intraocular neovascularization and are often difficult to treat. Currently, anti-vascular endothelial growth factor (VEGF) therapy has been developed and has demonstrated excellent results in treating macular edema, and many patients have avoided blindness. Unfortunately, there are problems with cases that do not respond to the anti-VEGF drugs and complications of administration. It is necessary to deepen the understanding of the physiological and pathological retinal roles of VEGF and to optimize the anti-VEGF therapy. There are also no drugs indicated for the regression of neovascularization itself. The solution to this problem is to develop novel therapies targeting other than VEGF. In this symposium review, we introduce the roles of VEGF in the ischemic retina and anti-angiogenic factors as promising therapeutic targets.

Keywords: macular edema; neovascularization; retina; vascular endothelial growth factor.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors* / therapeutic use
  • Animals
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Aptamers, Nucleotide* / therapeutic use
  • Diabetic Retinopathy / drug therapy*
  • Diabetic Retinopathy / etiology
  • Diabetic Retinopathy / pathology
  • Drug Development*
  • Humans
  • Macular Degeneration / drug therapy*
  • Macular Degeneration / etiology
  • Macular Degeneration / pathology
  • Mice
  • Molecular Targeted Therapy
  • Neovascularization, Pathologic*
  • Ranibizumab* / therapeutic use
  • Receptors, Vascular Endothelial Growth Factor* / therapeutic use
  • Recombinant Fusion Proteins* / therapeutic use
  • Retina / pathology*
  • Retinal Vein Occlusion / drug therapy*
  • Retinal Vein Occlusion / etiology
  • Retinal Vein Occlusion / pathology
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Vascular Endothelial Growth Factor A / physiology

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Aptamers, Nucleotide
  • Recombinant Fusion Proteins
  • Vascular Endothelial Growth Factor A
  • aflibercept
  • pegaptanib
  • Receptors, Vascular Endothelial Growth Factor
  • brolucizumab
  • Ranibizumab