摘要
在西方国家,视网膜静脉阻塞(RVO)是导致视力丧失的第二大原因。根据血管闭塞的部位,RVO通常分为旁路视网膜静脉阻塞(BRVO)和中央视网膜静脉阻塞(CRVO)。我们还没有完全探明视网膜静脉阻塞的发病机制,但是重要的是管腔内血栓形成通常是继发于多种疾病如高血压、高脂血症、糖尿病和血栓形成等。静脉循环堵塞引起毛细血管腔内压力升高,导致内出血和视网膜渗漏液,间质压力增加和随之而来的视网膜灌注减少。缺血可能会产生血管内皮生长因子(VEGF)的分泌,进一步导致血管渗漏和视网膜水肿。VEGF也因此在RVO发病中起主导作用。为改善这些患者的临床症状,体内注射抗VEGF药物使用已成为非常普遍的现象。目前,两种治疗RVO的抗VEGF剂(ranimizumab和aflibercept)已经被 FDA(美国食品药物管理局)和 EMA(欧洲药品局)批准。而另一种VEGF抑制剂(bevacizumab)在临床中常当作“标示外”使用。在临床试验中已经提出了许多治疗方案,如要每月注射或需要时再注射,但理想方案的治疗方案尚未确定。本文对视网膜静脉阻塞、ranibizumab,、bevacizumab、 aflibercept,血管内皮生长因子和黄斑水肿做了系统的总结。一个作者对数据进行分析,另一个负责检查。本文目的在于总结每一种药物现有的数据,专注于其有效性和安全性,试图比较他们的优势和缺点。
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。
图形摘要
Current Drug Targets
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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Cite this article as:
Claudio Campa, Giuseppe Alivernini, Elena Bolletta, Maurizio Battaglia Parodi and Paolo Perri , Anti-VEGF Therapy for Retinal Vein Occlusions, Current Drug Targets 2016; 17 (3) . https://dx.doi.org/10.2174/1573399811666150615151324
DOI https://dx.doi.org/10.2174/1573399811666150615151324 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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