Ranibizumab in Circulatory Disorder of Retinal Vein: an Evidence-based Approach

The discovery of anti-angiogenics or vascular endothelial growth factor inhibitors (anti-VEGF) agents is a clear breakthrough with exciting potential in medical management of retinal diseases.Ranibizumab is a humanized, affinitymatured VEGF antibody fragment that binds to and neutralizes all isoforms of VEGF, which has first received FDA approval for the treatment of macular edema due to both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO). The objective of this review is to evaluate the evidence and discuss the rationale behind the recent suggestions that pharmacotherapy by Ranibizumab may be useful in the treatment of such circulatory disorder of retinal vein as a retinal vein occlusion (RVO). The available evidence suggests that repeated early frequent treatment of RVO with the anti-VEGF agent ranibizumab, gives the best chance of achieving and stabilizing both optimal anatomical and visual outcomes in the short to medium term. There is no standard protocol regarding the optimal timing of initial treatment with ranibizumab and subsequent retreatment is yet to be formulated. Where multiple injections are likely to be required, the effectiveness and safety over longer periods has yet to be determined. With more research and experience into exploring the frequency and safety of currently available agentranibizumab , it is also likely that clinicians would achieve the best protocol when dealing with patients sufferring from circulatory disorder of the retinal vein.