The impact of locally administrated VEGF inhibitors on vascular homeostasis – controversies concerning safety of intravitreal therapy in AMD patients

Intravitreal vascular endothelial growth factor (VEGF) inhibitors constitutes currently the first-line treatment in neovascular age-

-related macular degeneration (AMD). By intravitreal application of the drug, the dosage can be kept low while maximizing

its effect on choroidal neovascularization and minimizing potential adverse systemic effects. However, the eye-blood barrier is

often disrupted in ophthalmic neovascular disorders and the drugs can be detected in circulating blood despite being administered as an intraocular injection. As patients with AMD constitute a high-risk population for cardiovascular events, the safety

of anti-VEGF therapies must be precisely and thoroughly assessed. In the present work, the recent reports documenting systemic safety of intravitreal VEGF inhibitors have been reviewed. Moreover, the novel methods to assess the potential systemic

effect on vascular homeostasis as the consequence of such therapy have been also discussed.