Progress in the treatment of corneal neovascularization with anti-VEGF drugs

The cornea is an important refractive medium of the visual system, which is avascular and transparent. Many physiological and pathological factors can destroy the balance of pro-angiogenic factors and anti-angiogenic factors, and then induce corneal neovascularization (CNV). Vascular endothelial growth factor (VEGF) is one of the most important mediators of angiogenesis and plays a key role in promoting CNV. Previous studies have mainly used local, subconjunctival, stromal injection and other methods to block the VEGF signaling pathway through multiple pathways and targets, thereby inhibiting the formation of CNV. However, the low bioavailability of drugs due to multiple physiological barriers in the eye, the complex microenvironment of the ocular surface, the side effects of drugs, and the differences in the mechanism of neovascularization from the fundus have led to the limitation of anti-VEGF therapy in the treatment of CNV. Improving the efficiency of drug delivery, decreasing adverse reactions, reducing damage to normal tissues, and lowering medical costs are the focus of current research. With the progress of science and technology, new drug delivery methods, such as nanowafers, liposomes, microporous drug delivery, mesenchymal stem cells, gene therapy, etc., have brought new ideas to improve the efficacy of anti-VEGF drugs in the treatment of CNV. In this paper, the mechanism of VEGF-induced CNV formation, the application of representative anti-VEGF drugs in the treatment of CNV, and the latest research progress of drug delivery methods are reviewed.

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