Intravitreal anti-vascular endothelial growth factor treatment for retinal diseases

Vascular endothelial growth factor (VEGF) is a protein secreted by cells to stimulate angiogenesis, a complex biological phenomenon essential for the development of new blood vessels. Aberrant angiogenesis has been implicated in various retinal diseases such as age-related macular degeneration, diabetic retinopathy, and retinal vein occlusion. Ever since the concept of angiogenesis was first introduced by Judah Folkman, and its crucial role in the pathophysiology of retinal diseases was elucidated by many scientists, much effort focused on identifying treatments has led to the development of anti-VEGF agents, which have become a critical component in the treatment of various retinal diseases associated with pathological angiogenesis. The application of various anti-VEGF agents has achieved not only the resolution of pathological lesions associated with aberrant angiogenesis, but also an improvement of visual acuity unattainable with conventional treatment modalities. Despite these major accomplishments with the use of anti-VEGF agents, there are still issues remaining to be addressed, such as how to treat non-responders to anti-VEGF agents, the need for repeated injections, and the economic burden on patients. This review highlights the outcomes from major clinical trials investigating the efficacy and safety of various anti-VEGF agents that are currently available and how they can be utilized in the daily clinical setting.