[Diabetic retinopathy--the mechanisms of the ocular neovascularization and the development of anti-angiogenic drugs]

Abstract

Ocular neovascularization contributes to severe visual loss of the patients with diabetic retinopathy (DR) which is the leading cause of blindness on adults of working age. The mechanisms of ocular neovascularization are not fully understood. Several growth factors, particularly vascular endothelial growth factor (VEGF), vasoactive peptides such as angiotensin II and adhesion molecules such as integrins are considered to contribute to the ocular neovascularization. VEGF is believed to play the key role in the development of DR. Ischemic hypoxia of retina is well known to be the potent stimulus for the production of VEGF. In addition, we have reported that reactive oxygen intermediates, advanced glycation end products and insulin-like growth factor-1, also all, may participate in the pathogenesis of DR through their ability to increase VEGF production. The trials for anti-angiogenic drugs is developing now for the treatment of DR. VEGF may be the most suitable target for the inhibition of the ocular neovascularization.