Retinal and Choroidal Neovascularization Antivascular Endothelial Growth Factor Treatments: The Role of Gene Therapy

J Ocul Pharmacol Ther. 2022 Oct;38(8):529-548. doi: 10.1089/jop.2022.0022. Epub 2022 Sep 19.

Abstract

Neovascularization in ocular vessels causes a major disease burden. The most common causes of choroidal neovascularization (CNV) are age-related macular degeneration and diabetic retinopathy, which are the leading causes of irreversible vision loss in the adult population. Vascular endothelial growth factor (VEGF) is critical for the formation of new vessels and is the main regulator in ocular angiogenesis and vascular permeability through its receptors. Laser therapy and antiangiogenic factors have been used for CNV treatment. Bevacizumab, ranibizumab, and aflibercept are commonly used anti-VEGF agents; however, high costs and the need for frequent intraocular injections are major drawbacks of anti-VEGF drugs. Gene therapy, given the potency of one-time treatment and no need for frequent injections offers the real possibility of such a lasting treatment, with fewer adverse effects and higher patient quality of life. Herein, we reviewed the role of gene therapy in the CNV treatment. In addition, we discuss the advantages and challenges of current treatments compared with gene therapy.

Keywords: AAV; VEGF; choroid neovascularization; gene therapy.

Publication types

  • Review

MeSH terms

  • Adult
  • Angiogenesis Inhibitors / therapeutic use
  • Bevacizumab / therapeutic use
  • Choroidal Neovascularization* / drug therapy
  • Choroidal Neovascularization* / genetics
  • Endothelial Growth Factors
  • Genetic Therapy
  • Humans
  • Intravitreal Injections
  • Quality of Life
  • Ranibizumab
  • Receptors, Vascular Endothelial Growth Factor
  • Recombinant Fusion Proteins / therapeutic use
  • Vascular Endothelial Growth Factor A / genetics

Substances

  • Angiogenesis Inhibitors
  • Bevacizumab
  • Endothelial Growth Factors
  • Ranibizumab
  • Receptors, Vascular Endothelial Growth Factor
  • Recombinant Fusion Proteins
  • Vascular Endothelial Growth Factor A