Can any other treatment beat anti-VEGF in macular edema?
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Macular edema (ME) is an eye disease condition that causes the sudden or chronic decrease in visual acuity. The condition arises from fluid accumulation within the macula, an area in the center of the retina, leading to vascular instability and the breakdown of the blood-retinal barrier (BRB). Characterization of the diseases is made by the swelling and thickening of the macula distorting a person’s central vision, causing a decline in visual acuity and eventually could lead to blindness.
Major causes of macular edema include diabetes, branch and central retinal vein occlusion, choroidal neovascularization, posterior uveitis, postoperative inflammation and central serous chorioretinopathy.
Fluid accumulation results from an imbalance between processes governing fluid entry and exit, when inner or outer blood-retinal barriers are disrupted. ME can arise from various conditions:
- 7 million subjects due to diabetes, called diabetic macular edema (DME)
- 3 million subjects due to vein occlusion
- 40% of visual impairment in patients with uveitis
- 5% of individuals older than 60 years of age due to neovascular age-related macular degeneration (AMD) in industrialized countries
ME treatment is a rapidly growing market with an increasing elderly population, and people living with diabetes. The anti-vascular endothelial growth factor (VEGF) therapy has revolutionized the treatment landscape for ME providing benefit to patients, however 30-50% of patients don’t respond or develop resistance to anti-VEGF treatment and the opportunity still remains for the development of novel compounds.