Anti-VEGF therapy for glaucoma

Abstract

Purpose of review: The role of antivascular endothelial growth factor (anti-VEGF) agents in treating various ophthalmic diseases is currently being investigated. There have been many advances in the understanding of how anti-VEGF agents work and speculation on when to implement them clinically for neovascular glaucoma. Recent studies exploring the utility of anti-VEGF agents for wound modulation after trabeculectomy reveal promising results.

Recent findings: Anti-VEGF agents have been shown to be beneficial in treating neovascular glaucoma. Their use leads to regression of both iris and angle neovascularization, intraocular pressure control when the angle remains open and, in many cases, prompts symptomatic improvement. In addition, research on the wound modulatory properties of anti-VEGF agents has revealed a dose-dependent inhibition of fibroblast proliferation. Studies exploring the use of anti-VEGF agents at time of trabeculectomy or in bleb revision procedures suggest a beneficial effect on bleb survival and subsequent improvement in intraocular pressure control. Prospective randomized clinical trials are still needed.

Summary: The recent use of anti-VEGF agents for neovascular glaucoma as well as wound modulation after trabeculectomy has shown great promise. Through future research, the antiangiogenic and antifibroblastic properties of anti-VEGF agents may prove to be beneficial in patients being treated for various forms of glaucoma.