Update on the Management of Diabetic Retinopathy: Anti-VEGF Agents for the Prevention of Complications and Progression of Nonproliferative and Proliferative Retinopathy
Diabetic retinopathy (DR) is a microvascular disease caused by poorly controlled blood glucose, and it is a leading cause of vision loss in people with diabetes. In this review we discuss the current management of DR with particular focus on the use of intraocular anti-vascular endothelial growth fa...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/13/5/1098 |
| _version_ | 1797599366170542080 |
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| author | Tyler A. Bahr Sophie J. Bakri |
| author_facet | Tyler A. Bahr Sophie J. Bakri |
| author_sort | Tyler A. Bahr |
| collection | DOAJ |
| description | Diabetic retinopathy (DR) is a microvascular disease caused by poorly controlled blood glucose, and it is a leading cause of vision loss in people with diabetes. In this review we discuss the current management of DR with particular focus on the use of intraocular anti-vascular endothelial growth factor (anti-VEGF) agents. Intraocular anti-VEGF agents were first studied in the 1990s, and now several of these agents are either FDA approved or used off-label as first-line treatments for DR. Recent evidence shows that anti-VEGF agents can halt the progression of markers of DR severity, reduce the risk of DR worsening, and reduce the onset of new macular edema. These significant benefits have been demonstrated in patients with proliferative DR and the milder nonproliferative DR (NPDR). A wealth of evidence from recent trials and meta-analyses has detailed the intraoperative and postoperative benefits of adjunctive anti-VEGF therapy prior to pars plana vitrectomy (PPV) for proliferative DR with vitreous hemorrhage. In this review, we also discuss literature comparing various anti-VEGF injection regimens including monthly, quarterly, as-needed, and treat and extend protocols. Combination protocols with panretinal photocoagulation (PRP) or PPV are also discussed. Current evidence suggests that anti-VEGF therapies are effective therapy for NPDR and PDR and may also provide significant benefits when used adjunctively with other DR treatment modalities such as PRP or PPV. |
| first_indexed | 2024-03-11T03:34:22Z |
| format | Article |
| id | doaj.art-53d30f29cfe64e9fa0fa43af9014cadc |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-11T03:34:22Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-53d30f29cfe64e9fa0fa43af9014cadc2023-11-18T02:08:39ZengMDPI AGLife2075-17292023-04-01135109810.3390/life13051098Update on the Management of Diabetic Retinopathy: Anti-VEGF Agents for the Prevention of Complications and Progression of Nonproliferative and Proliferative RetinopathyTyler A. Bahr0Sophie J. Bakri1Mayo Clinic, Department of Ophthalmology, 200 First St SW, Rochester, MN 55902, USAMayo Clinic, Department of Ophthalmology, 200 First St SW, Rochester, MN 55902, USADiabetic retinopathy (DR) is a microvascular disease caused by poorly controlled blood glucose, and it is a leading cause of vision loss in people with diabetes. In this review we discuss the current management of DR with particular focus on the use of intraocular anti-vascular endothelial growth factor (anti-VEGF) agents. Intraocular anti-VEGF agents were first studied in the 1990s, and now several of these agents are either FDA approved or used off-label as first-line treatments for DR. Recent evidence shows that anti-VEGF agents can halt the progression of markers of DR severity, reduce the risk of DR worsening, and reduce the onset of new macular edema. These significant benefits have been demonstrated in patients with proliferative DR and the milder nonproliferative DR (NPDR). A wealth of evidence from recent trials and meta-analyses has detailed the intraoperative and postoperative benefits of adjunctive anti-VEGF therapy prior to pars plana vitrectomy (PPV) for proliferative DR with vitreous hemorrhage. In this review, we also discuss literature comparing various anti-VEGF injection regimens including monthly, quarterly, as-needed, and treat and extend protocols. Combination protocols with panretinal photocoagulation (PRP) or PPV are also discussed. Current evidence suggests that anti-VEGF therapies are effective therapy for NPDR and PDR and may also provide significant benefits when used adjunctively with other DR treatment modalities such as PRP or PPV.https://www.mdpi.com/2075-1729/13/5/1098diabetic retinopathyvascular endothelial growth factorVEGFanti-VEGFintravitreal injectioneye |
| spellingShingle | Tyler A. Bahr Sophie J. Bakri Update on the Management of Diabetic Retinopathy: Anti-VEGF Agents for the Prevention of Complications and Progression of Nonproliferative and Proliferative Retinopathy Life diabetic retinopathy vascular endothelial growth factor VEGF anti-VEGF intravitreal injection eye |
| title | Update on the Management of Diabetic Retinopathy: Anti-VEGF Agents for the Prevention of Complications and Progression of Nonproliferative and Proliferative Retinopathy |
| title_full | Update on the Management of Diabetic Retinopathy: Anti-VEGF Agents for the Prevention of Complications and Progression of Nonproliferative and Proliferative Retinopathy |
| title_fullStr | Update on the Management of Diabetic Retinopathy: Anti-VEGF Agents for the Prevention of Complications and Progression of Nonproliferative and Proliferative Retinopathy |
| title_full_unstemmed | Update on the Management of Diabetic Retinopathy: Anti-VEGF Agents for the Prevention of Complications and Progression of Nonproliferative and Proliferative Retinopathy |
| title_short | Update on the Management of Diabetic Retinopathy: Anti-VEGF Agents for the Prevention of Complications and Progression of Nonproliferative and Proliferative Retinopathy |
| title_sort | update on the management of diabetic retinopathy anti vegf agents for the prevention of complications and progression of nonproliferative and proliferative retinopathy |
| topic | diabetic retinopathy vascular endothelial growth factor VEGF anti-VEGF intravitreal injection eye |
| url | https://www.mdpi.com/2075-1729/13/5/1098 |
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