Ocular angiogenesis: translating preclinical indications to successful clinical development

Angiogenesis-related ocular diseases such as age-related macular degeneration (AMD) or diabetic retinopathy have a high socioeconomic impact in western countries and are the leading causes of blindness. Conventional treatment modalities for AMD are of limited success. Inhibition of new vessel formation and targeting of pathological vessels seem to be the best choice in AMD. A variety of animal models mimic the relevant aspects of choroidal neovascularisation (CNV) and allow for therapy screening. Preclinical and clinical studies show that a variety of different strategies are very promising. Stategies include inhibition or blocking of vascular endothelial growth factor, a key player in angiogenesis), blocking specific receptors, application of naturally occurring angiogenesis inhibitors and gene therapy. However, the multistep pathways involved in ocular angiogenesis suggest that a cocktail approach is required for effective long-term treatment and prevention of CNV.