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Advancements in Anti-VEGF Treatments: Transforming the Landscape of Ocular Therapies
Medically reviewed by Tina Patel, Contact Lens Optician at Feel Good Contacts
Anti-VEGF (vascular endothelial growth factor) treatment is a type of medicine that can be used to help manage certain eye conditions and improve vision problems related to wet age-related macular degeneration (AMD). Learn more about this medicine as well as the ways it can be used to treat appropriate eye conditions.
Understanding anti-VEGF treatments
Some eye conditions cause irregular neovascularisation, which is caused by increased levels of vascular endothelial growth factor-A (VEGF). This is why the medicine to treat these conditions is called anti-VEGF.
When the body produces too much VEGF, it causes abnormal blood vessels to grow in the eye, which can be harmful and lead to low vision or blindness.
Anti-VEGF treatments can be used successfully to treat eye conditions that cause swelling or abnormal growth of blood vessels in eyes. Treatment involves injecting medicine into the eye to help preserve vision.
Common eye conditions treated with anti-VEGF therapies
This medicine can be used to treat the following eye conditions:
- Wet age-related macular degeneration
- Myopic choroidal neovascularisation (myopic CNV)
- Diabetic macular edema (DME/DMO)
- Macular oedema caused by retinal vein occlusion
There are several types of anti-VEGF medicines, all of which are safe and effective methods of managing the above eye conditions:
- Avastin (bevacizumab)
- Eylea (aflibercept)
- Lucentis (ranibizumab)
- Nexavar (sorafenib)
- Sprycel (dasatinib)
- Sutent (sunitinib)
- Tasigna (nilotinib)
- Votrient (pazopanib).
How is anti-VEGF administered?
Most anti-VEGF medicines are administered via intravitreal injections (injection of a drug into the vitreous body).
The eye will be numbed to minimise pain, and sometimes the eye will be held open using a device if the eyelids are likely to get in the way of the procedure. Then, the medicine is injected directly through the sclera (the white part of your eyes) and into the vitreous fluid that makes up the vitreous body in your eyes (this fluid is a jelly-like substance that gives your eyes their round shape).
The injection doesn’t hurt, and the patient usually doesn’t even see the needle going in. The whole procedure only takes a few seconds.
Advancements in Anti-VEGF Treatments
Traditional treatments for wet AMD such as bevacizumab, ranibizumab and aflibercept are effective, but not as practical because they require more frequent doses. New anti-VEGF treatments are being developed to give a longer duration for treatment effectiveness through continuous release of the drug.
Future directions and promising research areas
According to recent studies, the future for anti-VEGF treatment offers promising options for people at risk of neovascular age-related macular degeneration (nAMD), the advanced form of macular degeneration, by reducing or eliminating the need for injections. Some trial-stage treatments have shown efficacy at improving quality of life for patients who have been diagnosed with nAMD. These include:
- Longer acting medical agents (brolucizumab/abicipar have shown some success at 12-week dosing intervals)
- Sustained-release anti-VEGF treatment (The ranibizumab port delivery system/KSI-301/GB-102)
- Gene therapies (RGX-314/ADVM-022)
- New topical anti-VEGF therapies (PAN-90806)
What do you need to know about anti-VEGF treatments?
Anti-VEGF treatments help to relieve the swelling, discomfort and vision loss associated with overproduction of VEGF, a protein that produces blood vessels in the eyes naturally.
The best management for VEGF currently involves anti-VEGF treatment via injection. To ease discomfort or pain, an optician might also recommend other treatments to be used alongside intravitreal injections.
While the majority of topical treatments have not yet been successful enough in clinical trials to offer a complete treatment, developments are being made that show potential progress. It is popularly believed that gene therapy with viral vectors will offer a long-term solution to the eye condition in the future, as long as safe treatment progresses past research and development phases.
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