antiVEGF

Anti-VEGF refers to therapies that inhibit vascular endothelial growth factor, a major driver of angiogenesis and increased vascular permeability. By neutralizing VEGF ligands or blocking VEGF receptors, these drugs reduce abnormal vessel growth and leakage that underlie several blinding eye diseases and cancers.

Most ophthalmic anti-VEGF agents are delivered by intravitreal injection, with dosing schedules ranging from monthly to every two to three months after an initial loading phase. Systemic anti-VEGF drugs used in cancer are given by intravenous infusion and are typically administered on cycles in combination with chemotherapy or as monotherapy in certain settings.

In ophthalmology, anti-VEGF therapy is indicated for wet age-related macular degeneration, diabetic macular edema, diabetic retinopathy with macular edema, retinal vein occlusion–related macular edema, and neovascular or myopia-related pathologies. Common agents include bevacizumab, ranibizumab, aflibercept, brolucizumab, and faricimab.

In oncology, anti-VEGF therapy aims to inhibit tumor blood vessel formation and can improve progression-free survival in various solid tumors. Approved systemic drugs include bevacizumab, aflibercept, and ramucirumab, among others, used alone or with chemotherapy depending on tumor type and stage.

Adverse effects vary by route and agent. Ocular anti-VEGF injections can cause endophthalmitis, intraocular inflammation, or transient intraocular pressure rise. Systemic therapy may increase the risk of hypertension, arterial thromboembolism, wound-healing impairment, and proteinuria. Safety monitoring and patient selection are important considerations in anti-VEGF treatment.