ANGIOGENESIS IN PROLIFERATIVE DIABETIC RETINOPATHY: RERSPECTIVES OF ANTI-VEGF THERAPY (REVIEW OF LITERATURE)

Abstract

VEGF-mediated angiogenesis is a key mechanism of pathologic retinal neovascularization in the proliferative diabetic retinopathy (PDR). Therefore, the anti-VEGF therapy can be considered as a perspective approach for the treatment of this complication. In patients with the PDR the combination of anti-VEGF agents with a panretinal photocoagulation prevents a decrease of visual acuity, a development of macular edema and, according to some data, enhances a neovascularization regression. In patients with vitreous hemorrhages the anti-VEGF agents injection before the vitrectomy reduces the incidence of recurrent hemorrhages in intra- and postoperative period. In eyes with PDR complicated with neovascular glaucoma the intravitreal bevacizumab injection leads to a regression of iris and anterior angle vascularization. Currently, the most frequent data exist in the use of bevacizumab, the effects of ranibizumab and pegaptanib are investigated in a lesser extent, researches of aflibercept have been initiated recently. Future studies are required to estimate the necessary duration and effectiveness predictors of anti-VEGF therapy, as well as the best combinations of anti-VEGF agents with other treatment modalities.

Keywords

• proliferative diabetic retinopathy
• neovascularization
• angiogenesis
• bevacizumab
• ranibizumab
• pegaptanib
• aflibercept