Peep into anti-vascular endothelial growth factor

Anti-vascular endothelial growth factor (anti-VEGF) therapy has transformed the management of retinal vascular diseases over the past two decades. Beginning with the foundational identification of VEGF as the principal driver of ocular neovascularization, the field has evolved from early agents such as pegaptanib and bevacizumab to more potent molecules including ranibizumab, aflibercept, brolucizumab, and faricimab. In India, the landscape is shaped by unique economic and epidemiological factors, including a high burden of diabetic retinopathy and age-related macular degeneration, limited healthcare reimbursement, and the significant role of biosimilar ranibizumab products in expanding access. This article provides a comprehensive overview of the historical development, pharmacology, regulatory milestones, safety considerations, and current clinical use of anti-VEGF agents in the Indian context, with emphasis on strategies to deliver equitable, high quality retinal care across a diverse population.