Anti-VEGF Agents for Retinal Vascular Diseases

Established Agents

The American Academy of Ophthalmology recognizes ranibizumab as a recombinant humanized antibody fragment that binds and inhibits VEGF-A, FDA-approved for neovascular AMD, diabetic retinopathy, diabetic macular edema, and retinal vein occlusion 1
Bevacizumab is commonly used off-label for central-involved diabetic macular edema and other retinal vascular diseases, with the American Diabetes Association supporting its use as an alternative to other anti-VEGF agents 2, 3

Faricimab is a bispecific monoclonal antibody that neutralizes both VEGF-A and angiopoietin-2, offering dual pathway inhibition, and is recognized by the American Academy of Ophthalmology as an anti-VEGF agent for treating center-involved diabetic macular edema 4, 5
The American Academy of Ophthalmology recommends anti-VEGF administration every 4-8 weeks during the first 12 months, with fewer injections in subsequent years, for patients treated with faricimab 4

For center-involved diabetic macular edema with moderate visual impairment, aflibercept provides superior vision outcomes compared to bevacizumab, according to the American Diabetes Association 2, 3
The American Diabetes Association supports anti-VEGF therapy as first-line treatment for center-involved diabetic macular edema, with faricimab included among the recommended agents 5
Regular OCT monitoring is essential to evaluate treatment response and determine continuation criteria for patients treated with anti-VEGF agents, including faricimab 4