Anti-vascular endothelial growth factor therapy for ocular neovascular disease
Anti-vascular endothelial growth factor therapy for ocular neovascular disease
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DOI：
10.1097/icu.0b013e3282f0ca54
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发表时间：
2007-11-01
影响因子：
3.7
通讯作者：
Miller, Joan W.
中科院分区：
文献类型：
--
作者：
Andreoli, Christopher M.;Miller, Joan W.
综述的目的最近的研究表明，血管内皮生长因子（VEGF）是负责许多眼部病变，包括新生血管。在过去的几年中，几种靶向VEGF的新药物已可商购用于眼内使用。这些药物已经彻底改变了新生血管性年龄相关性黄斑变性的治疗，并且对其他致盲疾病如糖尿病性视网膜病变、早产儿视网膜病变和新生血管性青光眼具有巨大的潜力。最近的发现眼部新生血管形成中的VEGF抑制研究（VISION）试验首次表明，抗VEGF药物（哌加他尼）能够预防新生血管性年龄相关性黄斑变性的视力丧失。抗VEGF抗体雷珠单抗治疗新生血管性AMD的最小经典/隐匿性试验（MARINA）和抗VEGF抗体治疗AMD中主要经典脉络膜新生血管（锚）试验表明，雷珠单抗可预防新生血管性年龄相关性黄斑变性的中度视力丧失，并且首次有相当比例的患者恢复视力。较小的病例系列表明，贝伐单抗可使视网膜、虹膜和椎间盘新生血管消退。正在进行的试验正在研究抗VEGF治疗在早产儿视网膜病变、糖尿病视网膜病变和新生血管性青光眼中的效用。SummaryNewer抗VEGF疗法在治疗年龄相关性黄斑变性中显示出前所未有的疗效，许多患者的视力得到改善。正在进行的试验将有助于指导其在年龄相关性黄斑变性中的使用，并将其适应症扩展到许多其他致盲性疾病。
Purpose of reviewRecent research has shown that vascular endothelial growth factor (VEGF) is responsible for many ocular pathologies involving neovascularization. Over the past several years several new agents targeting VEGF have become commercially available for intraocular use. These agents have revolutionized the care of neovascular age related macular degeneration and have great potential for other blinding conditions such as diabetic retinopathy, retinopathy of prematurity, and neovascular glaucoma.Recent findingsThe VEGF Inhibition Study in Ocular Neovascularization (VISION) trial first showed that an anti-VEGF agent (pegaptanib) was able to prevent vision loss in neovascular age related macular degeneration. The Minimally Classic/ Occult Trial of Anti-VEGF Antibody Ranibizumab in the Treatment of Neovascular AMD (MARINA) and Anti-VEGF Antibody for the Treatment of Predominantly Classic Choroidal Neovascularization in AMD (ANCHOR) trials showed that ranibizumab prevented moderate vision loss in neovascular age related macular degeneration and for the first time that a substantial proportion of patients regained vision. Smaller case series have shown that bevacizumab can regress retinal, iris and disc neovascularization. Ongoing trials are investigating the utility of anti-VEGF therapy in retinopathy of prematurity, diabetic retinopathy, and neovascular glaucoma.SummaryNewer anti-VEGF therapies have shown unprecedented efficacy in treating age related macular degeneration with many patients experiencing improvement in vision. Ongoing trials will help guide their use in age related macular degeneration and expand their indications to many other blinding diseases.