The role of anti-VEGF agents in myopic choroidal neovascularization: Current standards and future outlook

Munk, Marion; Rückert, Rene; Zinkernagel, Martin; Ebneter, Andreas; Wolf, Sebastian (2016). The role of anti-VEGF agents in myopic choroidal neovascularization: Current standards and future outlook. Expert Opinion on Biological Therapy, 16(4), pp. 477-487. Informa Healthcare 10.1517/14712598.2016.1132696

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Introduction The global prevalence of pathologic myopia is 0.9-3.1%, and visual impairment is found in 0.1-0.5% of European and 0.2-1.4% of Asian studies. Myopic choroidal neovascularization (mCNV) affects 5.2-11.3% of pathologic myopia patients and is a leading cause of vision impairment in the working-age population. Characteristic morphological changes and visual-acuity decrease are diagnostic features. Vascular-Endothelial-Growth-Factor (VEGF) has been identified as a trigger for pathologic neovascularization in these highly myopic patients. Areas Covered We cover the epidemiology, pathology and diagnostic aspects of mCNV. The history of therapeutic interventions is described, followed by an overview of current standard-of-care (SOC)-blocking VEGF using bevacizumab (off-label), ranibizumab or aflibercept and improving vision up to 13.5-14.4 letters. Despite good efficacy, an unmet medical need remains. We summarize ongoing and future developments of new drugs to treat or potentially cure mCNV. Expert Opinion mCNV is a major global health concern. Early detection and treatment is key for a satisfying outcome. The current SOC, VEGF inhibitors, affords good therapeutic efficacy and reasonable disease stabilization with few intravitreal treatments per year. However, the long-term prognosis is still unsatisfactory, and side-effects like chorioretinal atrophy development are of concern. Therefore, efforts should be intensified to develop more effective therapies.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology

UniBE Contributor:

Munk, Marion; Zinkernagel, Martin; Ebneter, Andreas and Wolf, Sebastian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1471-2598

Publisher:

Informa Healthcare

Language:

English

Submitter:

Sebastian Wolf

Date Deposited:

22 Dec 2015 14:10

Last Modified:

15 Sep 2017 10:25

Publisher DOI:

10.1517/14712598.2016.1132696

PubMed ID:

26666589

Uncontrolled Keywords:

aflibercept; anti-VEGF; atrophy; bevacizumab; epidemiology; myopic CNV; pathologic myopia; ranibizumab; therapy

BORIS DOI:

10.7892/boris.74442

URI:

https://boris.unibe.ch/id/eprint/74442

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