IMR Press / FBL / Volume 28 / Issue 9 / DOI: 10.31083/j.fbl2809222
Open Access Review
The Safety of Anti-VEGF Treatment, in the Context of the Retinal Nerve Fibre Layer, in Patients with Wet Age-Related Macular Degeneration: A Review
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1 Department of Ophthalmology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
2 Doctoral School, Poznan University of Medical Sciences, 61-701 Poznań, Poland
*Correspondence: malgorzata.wichrowska@skpp.edu.pl (Małgorzata Wichrowska)
Front. Biosci. (Landmark Ed) 2023, 28(9), 222; https://doi.org/10.31083/j.fbl2809222
Submitted: 11 May 2023 | Revised: 29 June 2023 | Accepted: 17 August 2023 | Published: 25 September 2023
(This article belongs to the Special Issue Retinal Biology in Health and Disease)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Anti-vascular endothelial growth factor (VEGF) drugs are widely used in modern ophthalmology, especially in treating macular disorders like age-related macular degeneration or diabetic macular edema. Protocols for such treatments include repeated administration of intravitreal injections, with the volume of drug injected into the vitreous chamber seemingly high enough to cause an increase in intraocular pressure. Hence, questions might arise if such therapeutic approaches are safe for ocular tissue. Moreover, anti-VEGF compounds may theoretically harm the retinal nerve fibers due to the inhibition of VEGF and its neuroprotective effects. Thus, this manuscript aims to review the literature regarding studies evaluating the retinal nerve fiber layer (RNFL) in eyes receiving anti-VEGF treatment due to age-related macular degeneration. The RNFL was chosen as a subject of this review, as it is the innermost retinal layer exposed to the direct action of intravitreally administered drugs. The results of the available studies remain inconclusive. Most researchers seem to confirm the safety of the anti-VEGF treatment in wet age-related macular degeneration, at least regarding the retinal nerve fiber layer. However, some authors noticed that the influence of anti-VEGFs on RNFL could become apparent after more than thirty injections. Nonetheless, the authors of all studies agree that further, long-term observations are needed to help clinicians understand the effect of anti-VEGF treatment on the dynamics of changes in the thickness of retinal nerve fibers in patients with the wet form of age-related macular degeneration.

Keywords
age-related macular degeneration
anti-VEGF
aflibercept
bevacizumab
ranibizumab
retinal nerve fiber layer
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