In 2011, aflibercept (Eylea, Regeneron) would be approved for wet AMD based on the results of the VIEW trials that showed aflibercept dosed every two months was not inferior to ranibizumab dosed monthly. Pegaptanib’s success was short-lived, as the much more affordable off-label use of bevacizumab (reconstituted for intravitreal injection by a compounding pharmacy) and the 2006 FDA approval of Genentech’s on-label wet AMD drug ranibizumab (Lucentis) both eclipsed Macugen in clinical efficacy. Soon after, an anti-VEGF molecule was approved for the eye: pegaptanib (Macugen, originally Eyetech/Pfizer, now Bausch + Lomb), approved in December 2004 for treatment of neovascular age-related macular degeneration (wet AMD). The first was intravenous bevacizumab (Avastin, Genentech), which was FDA-approved for the treatment of colon cancer in February 2004. In the early 2000s, innovation leapt forward and anti-VEGF compounds began to be used therapeutically. Anti-VEGF injections are beneficial for a wide array of posterior segment complications. New compounds continue to be developed and tested to better resolve retinal issues.įig 1. The development of anti-VEGF injections has provided a medical option to patients with certain posterior segment issues that simply didn’t exist before. Animal models also revealed that artificially creating a hypoxic retina led to increased VEGF and that injecting VEGF into the eye induced iris neovascularization and neovascular glaucoma. The molecule now known as vascular endothelial growth factor (VEGF) was discovered and found to be present in much higher concentrations in eyes with neovascularization than in those without. I t was long theorized that regions of ischemic retina released some type of unknown factor that promoted growth of new vasculature ( i.e.
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