By F. Bandello, M. Battaglia Parodi, A.J. Augustin, P. Iacono, R.O. Schlingemann, U. Schmidt-Erfurth, F.D. Verbraak

The improvement of treatment with anti-angiogenics or vascular endothelial development issue inhibitors (anti-VEGF) has marked the start of a brand new period in neovascularization and macular edema remedy. Its major ambitions are the inhibition of progress and improvement of recent vessels besides the relief of vascular permeability. the benefits over traditional laser photocoagulation are obvious as laser remedy continually leaves scars and explanations a retinal sensitivity deterioration. beginning with an overview of therapy rules, this quantity covers all elements of anti-VEGF treatment for ophthalmological issues. specifically, particular chapters are devoted to age-related macular degeneration, degenerative myopia, angioid streaks, inflammatory ailments, hereditary dystrophies, retinal vein occlusion, diabetic retinopathy, ocular tumors, in addition to anterior section neovascularization. The ebook offers an replace at the software of anti-VEGF in ocular ailments to normal ophthalmologists in addition to retina experts.

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In addition, a larger size of pigment epithelial detachment is considered as a predictor for RPE tears. However, vision may be preserved despite RPE tears [98]. Although a pigment epithelial tear in neovascular AMD can represent natural history, it is suggested that clinicians should be aware of and monitor patients for the possibility of this complication after intravitreal injections of ranibizumab [99]. However, it remains to be determined if a pigment epithelial tear should be considered as a possible therapeutically induced complication or if it rather represents natural history in neovascular AMD.

Retina 2006;26:262–269. 38 Michels S, Rosenfeld PJ, Puliafito CA, et al: Systemic bevacizumab (Avastin) therapy for neovascular agerelated macular degeneration 12-week results of an uncontrolled open-label clinical study. Ophthalmology 2005;112:1035–1047. 39 Moshfeghi AA, Rosenfeld PJ, Puliafito CA, et al: Systemic bevacizumab (Avastin) therapy for neovascular age-related macular degeneration: 24-week results of an uncontrolled open-label clinical study. e1–12. 5 and 5 mg/kg systemic bevacizumab in neovascular age-related macular degeneration: 24-week results of an uncontrolled, prospective cohort study.

It binds to and inhibits all isoforms of vascular endothelial growth factor A (VEGF-A) [30]. Unlike ranibizumab it is glycosylated and has an Fc fragment. Bevacizumab is licensed for the intravenous administration for the treatment of malignant solid tumors [32–34] and is available for off-label use in the treatment of AMD-related CNV [34]. Preliminary preclinical studies in primates showed a lack of retinal penetration of an intravitreally injected full-length antibody directed against epithelial growth factor receptor, which had structural similarities with bevacizumab [35].

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