Anti-tumor necrosis factor alpha for retinal diseases: current knowledge and future concepts

Area of Science:

• Ophthalmology
• Immunology
• Pharmacology

Background:

• Tumor necrosis factor alpha (TNF-α) is a key cytokine in ocular inflammation, edema, neovascularization, and neurodegeneration.
• TNF-α blockers are established treatments for systemic inflammatory diseases and are used off-label for noninfectious uveitis.

Purpose of the Study:

• To review the role of TNF-α in ocular diseases.
• To evaluate the efficacy and safety of TNF-α blockers in ophthalmology.
• To discuss the potential of novel TNF-α inhibitors for retinal and choroidal diseases.

Main Methods:

• Literature review of studies on TNF-α blockers in ocular inflammatory and degenerative diseases.
• Analysis of preliminary data on intravenous and intravitreal administration of TNF-α inhibitors.
• Discussion of safety concerns and future research directions.

Main Results:

• Intravenous TNF-α blockers show potential for diabetic macular edema and neovascular age-related macular degeneration.
• Intravitreal use of TNF-α inhibitors raises safety concerns, including intraocular inflammation.
• Further studies on humanized antibodies and antibody fragments are needed.

Conclusions:

• TNF-α plays a significant role in various ocular pathologies.
• While systemic TNF-α blockers have shown promise, intravitreal administration requires careful consideration due to safety issues.
• Future research will clarify the optimal use of local and systemic TNF-α blockers for treating retinal and choroidal diseases.