Anti-VEGF in diabetic retinopathy and diabetic macular edema

ABSTRACT

Introduction: Anti-VEGF intravitreal injections have revolutionized the treatment of diabetic retinopathy and diabetic macular edema in particular. This review focuses on agents used in anti-VEGF treatment and documents evidence for their efficacy over laser photocoagulation in the treatment of diabetic macular edema.

Areas covered: This study documents data from major clinical trials evaluating the safety and efficacy of the following anti-VEGF drugs: ranibizumab (Lucentis), bevacizumab (Avastin) and aflibercept (Eylea). We also discuss the ocular and systemic side effects of intravitreal anti-VEGF therapy as well as the future direction of anti VEGF therapy.

Expert commentary: We describe some of the unknowns regarding anti-VEGF therapy including the lack of data on long term outcomes, the cost/benefit analysis over pan retinal laser treatment, and the heavy demand on patients for consistent follow up.

KEYWORDS:

• Diabetes
• diabetic retinopathy
• diabetic macular edema
• retina
• injection
• anti-VEGF

Declaration of interest

RP Singh has had research sponsored by Genentech, Alcon, Regeneron, Neurotech and Apellis and has acted as a consultant: for Shire, Regeneron, Genentech and Alcon. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

The authors declare an unrestricted grant from Research to Prevent Blindness.