Antivascular endothelial growth factor in diabetic retinopathy

Diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) represent the most common causes of vision loss in patients affected by diabetes mellitus. Diabetic retinopathy (DR) needs special attention because of its high public health impact and impact on quality of life of patients. Actually, laser retinal photocoagulation is the standard of care for the treatment of DR. However, laser treatment reduces the risk of moderate visual loss by approximately 50%, without a remarkable vision recovery. Thus, new approaches in the treatment of DR have been taken into account and, more specifically, the therapy employing antivascular endothelial growth factor (anti-VEGF) drugs could play a meaningful role. VEGF is a pluripotent growth factor that functions as an endothelial cell-specific mitogen and vasopermeability factor. Through these mechanisms VEGF plays a critical role in promoting angiogenesis and vascular leakage. A high level of VEGF has been detected in eyes presenting DME and PDR, and thereby VEGF is an attractive candidate as therapeutic target of pharmacological treatment in the management of DR. In the current chapter, the concepts and results of anti-VEGF therapy in the treatment of the DME and PDR are presented.