Indian Journal of Ophthalmology (Jan 2014)
Changing paradigms of anti-VEGF in the Indian scenario
- P Mahesh Shanmugam
Affiliations
- P Mahesh Shanmugam
- DOI
- https://doi.org/10.4103/0301-4738.126189
- Journal volume & issue
-
Vol. 62,
no. 1
pp. 88 – 92
Abstract
Anti-vascular endothelial growth factors (VEGF) agents have revolutionized the treatment of retinal diseases. Use of anti-VEGF agents in the Indian Scenario present some unique challenges considering the absence of compounding pharmacies, poor penetrance of health insurance and limited affordability of the citizens of a developing economy. To study the changing paradigms of anti-VEGF use in the Indian scenario, all articles published by Indian authors, data from web-based surveys amongst Indian vitreo-retinal specialists were reviewed. In the paucity of compounding pharmacies in India, fractionation and injection techniques differ from those of developed countries. Frequent anti-VEGF monotherapy offers the best anatomical and visual results, but economics of scale do not allow the same in the Indian scenario, resulting in PRN dosing and combination of anti-VEGF with laser photocoagulation, being the commonly employed treatment protocols.
Keywords
- Lasik
- corneal scars
- corneoplastique
- premium cataract surgery
- refractive complications
- radial keratotomy
- pterygium
- pinguecula
- astigmatism
- corneal scars
- Antioxidants
- electromagnetic ration
- glutathione
- lens
- oxidative stress
- 2-ethylpyridine
- apoptosis
- ARPE-19 cells
- cigarette smoke toxicant
- mitochondrial membrane potential
- reactive oxygen/nitrogen species
- Intacs
- keratoconus
- nomogram
- Allograft
- autograft
- cell-based therapy
- limbus
- limbal stem cell deficiency
- limbal transplantation
- niche
- stem cells
- Infant blindness
- iPhone
- middle-income countries
- non-physician graders
- Retcam
- retinopathy of prematurity (ROP)
- rural areas
- screening
- smart phones
- telemedicine
- tele-ophthalmology
- tele-ROP
- wide-field digital imaging
- Diode laser
- pattern laser
- retinal photocoagulation
- subthreshold micropulse laser
- yellow laser
- Eye movement perimeter
- glaucoma
- saccadic reaction time
- Adaptive optics
- cone count
- cone spacing
- retinal imaging
- Bevacizumab
- diabetic macular edema
- gene expression profile
- microarray analysis
- Aqueous humor
- biologics
- biological signatures
- cytokines
- intraocular inflammation
- multiplex bead assays
- Ganglion cell complex
- spectral domain optical coherence tomography
- surface abnormality ratio
- Anti-VEGF
- India
- treatment protocols