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Anti-angiogenic Therapy for Retinal Disease

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Pharmacologic Therapy of Ocular Disease

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 242))

Abstract

Recent breakthroughs in our understanding of the molecular pathophysiology of retinal vascular disease have allowed us to specifically target pathological angiogenesis while minimizing damage to the neurosensory retina. This is perhaps best exemplified by the development of therapies targeting the potent angiogenic growth factor and vascular permeability mediator, vascular endothelial growth factor (VEGF). Anti-VEGF therapies, initially introduced for the treatment of choroidal neovascularization in patients with age-related macular degeneration, have also had a dramatic impact on the management of retinal vascular disease and are currently an indispensable component for the treatment of macular edema in patients with diabetic eye disease and retinal vein occlusions. Emerging evidence supports expanding the use of therapies targeting VEGF for the treatment of retinal neovascularization in patients with diabetic retinopathy and retinopathy of prematurity. However, VEGF is among a growing list of angiogenic and vascular hyperpermeability factors that promote retinal vascular disease. Many of these mediators are expressed in response to stabilization of a single family of transcription factors, the hypoxia-inducible factors (HIFs), that regulate the expression of these angiogenic stimulators. Here we review the basic principles driving pathological angiogenesis and discuss the current state of retinal anti-angiogenic pharmacotherapy as well as future directions.

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Conflict of Interest

Johns Hopkins has filed a patent application on the use of technology to modulate the levels of ANGPTL4 for the treatment of ocular neovascular disease (US patent 14/394, 152). This work was supported by the National Eye Institute, National Institutes of Health Grant, K08-EY021189 (AS) and an Unrestricted Grant from Research to Prevent Blindness (AS), and the Heed Ophthalmic Foundation Fellows Grant (YMP) and the National Eye Institute, National Institutes of Health Grant, K12-EY022299-4 (YMP). Dr. Sodhi gratefully acknowledges the support he receives as a Special Scholar Award recipient from Research to Prevent Blindness, Inc. The funding organizations had no role in the design or conduct of this research.

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Authors and Affiliations

  1. Kellogg Eye Center, University of Michigan School of Medicine, 1000 Wall Street, Ann Arbor, MI, 48105, USA

    Yannis M. Paulus

  2. Wilmer Eye Institute, Johns Hopkins University School of Medicine, 400 N. Broadway St., Smith Building, 4039, Baltimore, MD, 21287, USA

    Akrit Sodhi

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  1. Yannis M. Paulus
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  2. Akrit Sodhi
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Correspondence to Akrit Sodhi .

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  1. Akrivista and Whitecap Biosciences, Mission Viejo, California, USA

    Scott M. Whitcup

  2. Illinois Eye and Ear Infirmary, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA

    Dimitri T. Azar

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Paulus, Y.M., Sodhi, A. (2016). Anti-angiogenic Therapy for Retinal Disease. In: Whitcup, S., Azar, D. (eds) Pharmacologic Therapy of Ocular Disease. Handbook of Experimental Pharmacology, vol 242. Springer, Cham. https://doi.org/10.1007/164_2016_78

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