Title:Anti-VEGF Therapy for Retinal Vein Occlusions
Volume: 17
Issue: 3
Author(s): Claudio Campa, Giuseppe Alivernini, Elena Bolletta, Maurizio Battaglia Parodi and Paolo Perri
Affiliation:
关键词:
Aflibercept ，bevacizumab ，黄斑水肿，ranibizumab ，视网膜静脉阻塞，血管内皮生长因子。
摘要: Retinal vein occlusion (RVO) is the second most common cause of visual loss in the Western
World. RVO is usually classified into branch RVO (BRVO) and central RVO (CRVO) according
to the anatomical site of the vascular occlusion. The pathogenesis of RVO is not yet fully understood,
however an important event is the intraluminal thrombus formation, which is usually secondary to
several conditions such as hypertension, hyperlipidemia, diabetes and thrombophilia. The blockage of
venous circulation causes an elevation of intraluminal pressure in the capillaries, leading to hemorrhages
and leakage of fluid within the retina, increase of interstitial pressure and a consequent reduction
of retinal perfusion. Ischemia may develop resulting in secretion of vascular endothelial growth factor (VEGF) that
causes further vascular leakage and retinal oedema. VEGF has therefore a leading role in RVO pathogenesis and symptoms.
As a consequence use of anti-VEGF agents by intravitreal injections has become very common with the aim to improve
the clinical outcomes in these patients. Currently 2 anti-VEGF agents (ranimizumab and aflibercept) have been
FDA (Food and Drug Administration) and EMA (European Medicine Agency) approved for the treatment of RVO, while
another VEGF inhibitor (bevacizumab) is often used “off-label” in clinical practice. Many treatment regimens have been
suggested in the clinical trials with these drugs, as monthly injections or injections when needed, however the ideal regimen
has not been defined yet. We conducted a systematic review searching MEDLINE for the following terms: retinal
vein occlusion, ranibizumab, bevacizumab, aflibercept, vascular endothelial growth factor, macular oedema. Data were
extracted by one author (AG and BE) and checked by a second (BPM, CC). Aim of this article was to review available
data for each drug, focusing on their efficacy and safety trying to compare their advantages and limits.
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