Correspondence to Author: Marianne L Shahsuvaryan, MD, PhD, DSc., Prof.. 

Department of Ophthalmology, Yerevan State Medical University, Yerevan, 0001 Armenia

INTRODUCTION:

The cases of potentially blinding eye diseases, such as diabetic retinopathy (DR), retinal vein occlusion (RVO), age-related macular degeneration (AMD) and cataract are exponencially growing worldwide due to population aging and rising life expectancy [1]. At present really only cataract is a surgically completely treated cause of blindness. Majority of ocular disorders, especially retinal vascular diseases require a medical therapy with a long-life follow-up. Two decades ago ocular therapeutic armamentarium was enriched by vascular endothelial growth factor VEGF. inhibitors, opening a new era in ophthalmopharmacotherapy [2,3]. Importantly, this medical option universally targets VEGF overexpression pathway involved in multiple eye diseases and directed to induce a retinal angiogenesis, macular edema, etc [4]. It is well-recognized that despite given intravitreally in small amounts, VEGF inhibitors spread into blood stream reaching physiologically VEGF-depending end-organs, such as the heart, the kidney, etc [5]. With this in mind, it should be considered that intraocular antiangiogenic therapy could be associated with undesirable systemic cardiovascular and renal adverse events (AEs). Accumulating evidence has suggested the cases of myocardial infarction, ischemic attacks thrombosis, pulmonary embolism, cerebrovascular accidents, proteinuria related to local administration of anti-VEGF agents in AMD, RVO, DR [6]. Recently, cardiovascular and renal safety concerns have gained a special attention [7-15]. It should be emphasized that systemic safety is extremally important, taken into account that vast majority of patients with retinal vascular disorders have a systemic co-morbidity- systemic hypertension, atherosclerosis, diabetes, etc [16,17]. This finding highlights the urgent need for thoughtful therapy. Currently, retinal diseases management includes two unresolved challenges-medical and healthcare.

Citation:

Dr. Marianne L Shahsuvaryan, Ocular Pharmacotherapeutic Challenges. World Journal of Clinical Surgery 2025.