Management of Neovascular AMD

VEGF is the most important regulator of angiogenesis and a potent promoter of vascular permeability in different ocular diseases, including AMD. For this reason, VEGF is a key target in treating ocular neovasculari-zation. Two anti-VEGF agents have achieved regulatory approval, with others in clinical trials. Clinical trials have shown that intravitreal ranibizumab is safe drug and effective, being the first agent to promote visual acuity improvement in patients with wet AMD. Bevacizumab, a monoclonal antibody against VEGF, was approved for intravenous, systemic therapy for different types of cancer. It has been used off-label as an intravitreal injection in wet AMD since 2005 with clinical results similar to ranibizumab. CATT head-to-head trial comparing bevacizumab versus ranibizumab demonstrated that they have similar outcomes when the same treatment regimen is applied. New promising anti-VEGF drugs (VEGF-Trap, KH902, and Pazopanib) are in ongoing clinical trials.