Advancements in Neovascular Ophthalmopathy: Therapeutic Strategies and Future Prospects

Abnormal ocular angiogenesis is a key factor in the development of many blinding ocular diseases, including wet age-related macular degeneration (wAMD), diabetic macular oedema (DME), pathologic myopia with choroidal neovascularization (PM-CNV), and neovascular glaucoma (NVG). The development of anti-neovascular drugs and ocular drug delivery systems (DDS) offers more possibilities for the treatment of neovascular eye diseases. In addition to anti-vascular endothelial growth factor (anti-VEGF) agents, the discovery of other anti-angiogenic targets, such as somatostatin, endostatin and pigment epithelium-derived factor (PEDF), has been a boon to patients with poor anti-VEGF efficacy and led to a reduction in the adverse effects of long-term VEGF inhibition. Gene therapy is currently a very promising approach for the treatment of neovascular ophthalmopathy. The rapid development of gene therapy and the potential for viral vector-mediated gene delivery to achieve sustained expression of anti-vascular substances at the lesion site will mitigate the risks associated with frequent intraocular injections for patients. This review provides an overview of several neovascular ophthalmopathies, discusses the use of anti-vascular therapeutic agents and common DDS, and summarizes treatment strategies and future perspectives for neovascular ophthalmopathy.