Vascular endothelial growth factor (VEGF) has been implicated in the pathogenesis of a variety of ocular vascular conditions. The macula, with the fovea at its center, has the highest photoreceptor concentration and is where visual detail is discerned. The anti-VEGF agent’s brolucizumab-dbll (Beovu®), ranibizumab (Lucentis™), ranibizumab-nuna (ByoovizTM) – biosimilar to Lucentis, ranibizumab injection ocular implant (SusvimoTM), bevacizumab (Avastin®), pegaptanib (Macugen®), and aflibercept (Eylea ™), and faricimab-svoa (VabysmoTM) are used to treat certain ocular disorders and are given by intravitreal injection.
Symptomatic vitreomacular adhesion (VMA) occurs when the vitreous (jelly-like substance inside the eye) has persistent adhesion to the macula. Symptomatic VMA symptoms such as distorted or decreased vision are a result of this persistent adhesion. If the disease progresses, the symptoms can worsen and may result in central vision defect and loss of vision. Ocriplasmin (Jetrea®), a proteolytic enzyme, is a single intravitreal injection indicated for the treatment of symptomatic VMA. It breaks down proteins in the eye responsible for VMA.