Vascular endothelial growth factor (VEGF) plays a pivotal role in stimulating the growth of pathological subretinal choroidal neovascularisation (CNV). The increased production of VEGF and subsequent CNV formation can occur in degenerative, inflammatoryand vascular diseases of the retina and choroid, often leading to severe visual impairment. Anti-VEGF agents which are readily available today are much better, more potent and longer acting in comparison with previous treatment modalities and therefore have dramatically improved the prognosis of patients with CNV. There are four intravitreal anti-VEGF pharmacotherapies proven by large prospective, multicentre, randomised trials to be effective in the treatment of age-related macular degeneration (AMD)-related CNV: pegaptanib(Macugen®, Eyetech Pharmaceuticals, Palm Beach Gardens, FL), ranibizumab (Lucentis®, Genentech, Inc., South San Francisco, CA), bevacizumab (Avastin®, Genentech, Inc., South San Francisco, CA) and VEGF Trap-Eye (Eylea®Regeneron, Tarrytown, NY). However, there are still many challenges and unanswered questions regarding the optimal anti-VEGF pharmacotherapy agent, the best clinical treatment regimen, the most effective dosage, the optimal injection frequency and the duration of treatment. The heavy burden of frequent injections on the elderly patient population and physicians begs for a simpler way of drug administration or development
of more potent compounds.
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