Vascular endothelial growth factor biology: clinical implications for ocular treatments

Decades of research on vascular endothelial growth factor (VEGF) have reached fruition with the recent development of intravitreal anti-VEGF treatments for exudative age-related macular degeneration. VEGF is a critical regulator of angiogenesis and vascular permeability with diverse roles, both pathological and physiological, during development and adulthood. The aim of this article is to review aspects of VEGF biology that may be relevant to the clinical use of anti-VEGF agents in ophthalmology: molecular characteristics and isoforms of VEGF; its roles in vasculogenesis, vascular maintenance and angiogenesis; systemic effects of VEGF inhibition; and properties of current anti-VEGF agents.