Vascular endothelial Growth factor (VEGF) is a protein produced in the human body which is responsible for production of new vessels and maintaining them. Under abnormal conditions like diabetic retinopathy, blood vessels obstruction and age related macular degeneration it causes formation of abnormal vessels which bleed, leak and ultimately lead to scar formation and vision loss
Anti Vascular endothelial Growth factor (anti VEGF) agents a group of medications which block the activity of VEGF and thus mitigate the abnormal effects of VEGF
| Bevacizumab | Ranibizumab | Aflibercept | Brolucizumab |
Molecule | Monoclonal antibody | Antibody fragment | Fusion protein | Single chain antibody |
Molecular weight | 149 kDa | 48kDa | 97-115 kDa | 26 kDa |
Clinical dose | 1.25 mg | 0.5 mg | 2 mg | 6 mg |
FDA approval | Not approved | Approved | Approved | Approved |
Intravitreal anti VEGF activity | 4 weeks | 4 weeks | Upto 12 weeks | Upto 12 weeks |
Anti VEGF agents when administered under appropriate conditions act at molecular level countering the action of VEGF and thereby reducing the morbidity.
Many diseases which were considered untreatable earlier like age related macular degeneration are rendered treatable, enabling patients maintain quality vision and subsequent improvement in quality of life
Ocular manifestation of systemic diseases with diabetes hypertension are also now treated with anti VEGF agents, with quality vision being restored and maintained.
Disease | Pathology | Benefits |
Wet age related macular degeneration | Abnormal vessels at the back of the eye leak fluid and blood, leads to drop in vision | Abnormal vessels regress with resorption of fluids with subsequent improvement of vision |
Diabetic macular edema | Leakage of fluid due at the back of the eye leading to swelling and vision drop | Prevent leakage and reduce swelling |
Proliferative diabetic retinopathy | Abnormal vessels on the retina which bleed | Regression of abnormal vessels |
Retinal vein occlusion | Swelling of retina due to obstruction of retinal blood vessels | Resolution of swelling with improvement of vision |
The doctor examining you will prescribe the appropriate agents as per the disease process and systemic illness. Active bleeding or fluid leak at the back of the eye called macula warrants urgent treatment. The doctor will perform appropriate scans to confirm, quantify and monitor the progress of the disease. Vision is measured and is one of the yardstick for monitoring response to treatment
Antibiotic drops are prescribed for usage after injection in the eye.
Written by: Dr. Mohanraj – Consultant Ophthalmologist, Coimbatore
The injection is done with a fine needle and mild pain which is well tolerated by most of the patients is there.
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