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Diabetologia
Published in: Diabetologia 9/2008

01-09-2008 | Commentary

Is blockade of vascular endothelial growth factor beneficial for all types of diabetic retinopathy?

Authors: D. N. Sang, P. A. D’Amore

Published in: Diabetologia | Issue 9/2008

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Excerpt

The pathophysiology of diabetic retinopathy leads to the clinical findings of increased retinal vascular permeability and progressive retinal ischaemia, and vascular endothelial growth factor (VEGF) has been identified as a key mediator in diabetic retinopathy. Loss of vision is most commonly a direct or indirect sequela of VEGF-mediated pathology, with ischaemia and/or oedema, retinal neovascularisation, vitreous haemorrhage and traction retinal detachment. Laser photocoagulation has been the standard of care in the treatment of both diabetic macular oedema (DMO) and proliferative diabetic retinopathy (PDR), and has been documented as reducing visual loss [1, 2]. In the Early Treatment Diabetic Retinopathy Study (ETDRS), laser treatment for PDR reduced the incidence of severe vision loss by 50%, and laser treatment for DMO reduced the incidence of moderate visual loss by 50% [2]. Although benefits were statistically significant, visual gains were limited. …
Literature
1.
Kinyoun J, Barton F, Fisher M, Hubbard L, Aiello L, Ferris F 3rd (1989) Detection of diabetic macular edema. Ophthalmoscopy versus photography—Early Treatment Diabetic Retinopathy Study report number 5. The ETDRS Research Group. Ophthalmology 96:746–750PubMed
2.
Early Treatment Diabetic Retinopathy Study Research Group (1991) Early Treatment Diabetic Retinopathy Study design and baseline patient characteristics. ETDRS report number 7. Ophthalmology 98:741–756
3.
4.
Rosenfeld PJ, Brown DM, Heier JS et al (2006) Ranibizumab for neovascular age-related macular degeneration. N Engl J Med 355:1419–1431PubMedCrossRef
5.
Brown DM, Regillo CD (2007) Anti-VEGF agents in the treatment of neovascular age-related macular degeneration: applying clinical trial results to the treatment of everyday patients. Am J Ophthalmol 144:627–637PubMedCrossRef
6.
Miller JW, Adamis AP, Shima DT et al (1994) Vascular permeability factor/vascular endothelial cell growth factor is temporally and spatially correlated with ocular angiogenesis in a primate model. Am J Pathol 145:574–584PubMed
7.
Aiello LP, Avery RL, Arrigg PG et al (1994) Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other ocular disorders. N Engl J Med 331:1480–1487PubMedCrossRef
8.
Avery RL (2006) Regression of retinal and iris neovascularization after intravitreal bevacizumab (Avastin) treatment. Retina 26:352–354PubMedCrossRef
9.
Tolentino MJ, Miller JW, Gragoudas ES, Chatzistefanou K, Ferrara N, Adamis AP (1996) Vascular endothelial growth factor is sufficient to produce iris neovascularization and neovascular glaucoma in a nonhuman primate. Arch Ophthalmol 114:964–970PubMed
10.
Aiello LP, Bursell SE, Clermont A et al (1997) Vascular endothelial growth factor-induced retinal permeability is mediated by protein kinase C in vivo and suppressed by an orally effective beta-isoform-selective inhibitor. Diabetes 46:1473–1480PubMedCrossRef
11.
Cunningham ET Jr, Adamis AP, Altaweel M et al (2005) A Phase II randomized double-masked trial of pegaptanib, an anti-vascular endothelial growth factor aptamer, for diabetic macular edema. Ophthalmology 112:1747–1757PubMedCrossRef
12.
Nguyen QD, Tatlipinar S, Shah SM et al (2006) Vascular endothelial growth factor is a critical stimulus for diabetic macular edema. Am J Ophthalmol 142:961–969PubMedCrossRef
13.
Chun DW, Heier JS, Topping TM, Duker JS, Bankert JM (2006) A pilot study of multiple intravitreal injections of ranibizumab in patients with center-involving clinically significant diabetic macular edema. Ophthalmology 113:1706–1712PubMedCrossRef
14.
Arevalo JF, Fromow-Guerra J, Quiroz-Mercado H et al (2007) Primary intravitreal bevacizumab (Avastin) for diabetic macular edema: results from the Pan-American Collaborative Retina Study Group at 6-month follow-up. Ophthalmology 114:743–750PubMedCrossRef
15.
Haritoglou C, Kook D, Neubauer A et al (2006) Intravitreal bevacizumab (Avastin) therapy for persistent diffuse diabetic macular edema. Retina 26:999–1005PubMedCrossRef
16.
Shimura M, Nakazawa T, Yasuda K et al (2008) Comparative therapy evaluation of intravitreal bevacizumab and triamcinolone acetonide on persistent diffuse diabetic macular edema. Am J Ophthalmol 145:854–861PubMedCrossRef
17.
Weis SM, Cheresh DA (2005) Pathophysiological consequences of VEGF-induced vascular permeability. Nature 437:497–504PubMedCrossRef
18.
Schneck ME, Shupenko L, Adams AJ (2008) The fast oscillation of the EOG in diabetes with and without mild retinopathy. Doc Ophthalmol 116:231–236PubMedCrossRef
19.
Maharaj AS, Saint-Geniez M, Maldonado AE, D’Amore PA (2006) Vascular endothelial growth factor localization in the adult. Am J Pathol 168:639–648PubMedCrossRef
20.
D’Amore PA (2007) Vascular endothelial cell growth factor-A: not just for endothelial cells anymore. Am J Pathol 171:14–18PubMedCrossRef
21.
Zachary I (2005) Neuroprotective role of vascular endothelial growth factor: signalling mechanisms, biological function, and therapeutic potential. Neurosignals 14:207–221PubMedCrossRef
22.
Kilic U, Kilic E, Jarve A et al (2006) Human vascular endothelial growth factor protects axotomized retinal ganglion cells in vivo by activating ERK-1/2 and Akt pathways. J Neurosci 26:12439–12446PubMedCrossRef
23.
Nishijima K, Ng Y-S, Zhong L et al (2007) VEGF-A is a survival factor for retinal neurons and a critical neuroprotectant during the adaptive response to ischemic injury. Am J Path 171:53–67PubMedCrossRef
24.
Saint-Geniez M, D’Amore PA (2004) Development and pathology of the hyaloid, choroidal and retinal vasculature. Int J Dev Biol 48:1045–1058PubMedCrossRef
25.
Kamba T, Tam BY, Hashizume H et al (2006) VEGF-dependent plasticity of fenestrated capillaries in the normal adult microvasculature. Am J Physiol Heart Circ Physiol 290:H560–H576PubMedCrossRef
26.
Maharaj AS, Walshe TE, Saint-Geniez M et al (2008) VEGF and TGF-beta are required for the maintenance of the choroid plexus and ependyma. J Exp Med 205:491–501PubMedCrossRef
27.
Peters S, Heiduschka P, Julien S et al (2007) Ultrastructural findings in the primate eye after intravitreal injection of bevacizumab. Am J Ophthalmol 143:995–1002PubMedCrossRef
28.
Maharaj AS, Saint-Geniez M, Walshe TE et al (2008) VEGF is required for neuroretina survival and function. Invest Ophthalmol Vis Sci 49:E–5836 (Abstract)
29.
Inan UU, Avci B, Kusbeci T, Kaderli B, Avci R, Temel SG (2007) Preclinical safety evaluation of intravitreal injection of full-length humanized vascular endothelial growth factor antibody in rabbit eyes. Invest Ophthalmol Vis Sci 48:1773–1781PubMedCrossRef
30.
Saint-Geniez M, Maldonado AE, D’Amore PA (2006) VEGF expression and receptor activation in the choroid during development and in the adult. Invest Ophthalmol Vis Sci 47:3135–3142PubMedCrossRef
31.
Rosenfeld PJ, Brown DM, Heier JS et al (2006) Ranibizumab for neovascular age-related macular degeneration. N Engl J Med 355:1419–1431PubMedCrossRef
32.
Brown DM, Kaiser PK, Michels M et al (2006) Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med 355:1432–1444PubMedCrossRef
33.
van Wijngaarden P, Coster DJ, Williams KA (2005) Inhibitors of ocular neovascularization: promises and potential problems. JAMA 293:1509–1513PubMedCrossRef
34.
Hurwitz H, Fehrenbacher L, Novotny W et al (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350:2335–2342PubMedCrossRef
35.
Yang B, Cross DF, Ollerenshaw M, Millward BA, Demaine AG (2003) Polymorphisms of the vascular endothelial growth factor and susceptibility to diabetic microvascular complications in patients with type 1 diabetes mellitus. J Diabetes Complications 17:1–6PubMedCrossRef
36.
Buraczynska M, Ksiazek P, Baranowicz-Gaszczyk I, Jozwiak L (2007) Association of the VEGF gene polymorphism with diabetic retinopathy in type 2 diabetes patients. Nephrol Dial Transplant 22:827–832PubMedCrossRef
Metadata
Title
Is blockade of vascular endothelial growth factor beneficial for all types of diabetic retinopathy?
Authors
D. N. Sang
P. A. D’Amore
Publication date
01-09-2008
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 9/2008
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-008-1078-9

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