Ингибиторы VEGF в глаукомной хирургии
- Авторы: Мамиконян В.Р.1, Петров С.Ю.1, Сафонова Д.М.1
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Учреждения:
- ФГБНУ «НИИ глазных болезней»
- Выпуск: Том 9, № 1 (2016)
- Страницы: 47-55
- Раздел: Статьи
- URL: https://journals.rcsi.science/ov/article/view/2943
- DOI: https://doi.org/10.17816/OV9147-55
- ID: 2943
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Аннотация
Фактор роста эндотелия сосудов - сигнальный белок, отвечающий за васкулогенез, ангиогенез, развитие незрелых кровеносных сосудов, а также стимулирующий проницаемость мелких кровеносных сосудов. На сегодняшний день известны изоформы VEGF-A, VEGF-B, VEGF-C, VEGF-В и PGF. Считается, что наиболее важную роль в организме человека играет VEGF-A, способствующий неоангиогенезу и образованию фибробластов. Повышенная активность VEGF может приводить к развитию и ухудшению патологических состояний, в том числе онкологических. В обзоре представлена история доклинических и клинических исследований основных ингибиторов VEGF - бевацизумаба и ранибизумаба, дан краткий обзор других препаратов из этого лечебного класса. Описаны показания к применению антиангиогенных препаратов в офтальмологии и возможности их использования по неофициальным показаниям (off-label). Приведены исследования с интравитреальным и введением в переднюю камеру ингибиторов VEGF при неоваскуляризации сетчатки, хориоидеи, радужки и угла передней камеры. Описаны примеры эффективности применения анти-VEGF перед имплантацией клапана Ахмеда и в случае неоваскулярной глаукомы, вызванной лучевой терапией злокачественных образований глаза. В процессе послеоперационного заживления раны и рубцевания принимают участие фибробласты теноновой капсулы. Согласно последним исследованиям, этот процесс может подавляться ингибиторами ангиогенеза. Приведён обзор использования антиангиогенных препаратов для подавления пролиферации фибробластов в послеоперационном периоде антиглаукомных операций в качестве монотерапии и в сочетании с митомицином С или 5-фторурацилом. Описаны исследования по применению ингибиторов VEGF при проведении послеоперационного нидлинга.
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Вардан Рафаэлович Мамиконян
ФГБНУ «НИИ глазных болезней»
Email: info@eyeacademy.ru
профессор, д-р мед. наук, заместитель директора
Сергей Юрьевич Петров
ФГБНУ «НИИ глазных болезней»
Email: post@glaucomajournal.ru
канд. мед. наук, старший научный сотрудник отдела глаукомы
Дарья Михайловна Сафонова
ФГБНУ «НИИ глазных болезней»
Email: dmsafonova@gmail.com
врач-офтальмолог, аспирант
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