Anti-VEGF side effects

A number of anti-VEGF-A therapies are now being used to treat eye diseases including wet macular degeneration, diabetic macular oedema and retinopathy of prematurity. A recent study raises concerns about the effects of continuous inhibition of intraocular VEGF on the ciliary body. The researchers looked at VEGF-A expression during ciliary body development in a mouse model. This confirmed that VEGF-A plays a key role at the onset of ciliary process formation. Neutralisation of systemic VEGF-A produced thinning of the non-pigmented epithelium, vacuolization of the pigmented epithelium, loss of capillary fenestrations and thrombosis. These changes were associated with impaired ciliary body function, as evidenced by decreased intraocular pressure. The researchers conclude that VEGF-A has an important role in ciliary body homeostasis and so the potential for undesired off-target effects should be considered with the chronic use of anti– VEGF-A therapies.

KM Ford et al., Investigative Ophthalmology & Visual Science, “Expression and Role of VEGF-A in the Ciliary Body,†November 2012 53:7520-7527.