The role of anti-VEGF therapy in the treatment of age-related macular degeneration: a comparative analysis of drug efficacy

Rationale: The article examines modern aspects of anti-VEGF therapy as the primary treatment method for the neovascular form of age-related macular degeneration (AMD). The pathophysiological mechanisms of disease development, including the role of vascular endothelial growth factor in pathological neovascularization, are described. Objective: To conduct a comparative analysis of the efficacy and safety of anti-VEGF drugs used in the treatment of neovascular AMD, considering their pharmacological characteristics, administration regimens, and potential adverse effects. Methods: A review of scientific literature was conducted, analyzing studies indexed in international bibliographic databases, including PubMed, Scopus, Web of Science, and the Cochrane Library, from 2019 to the present. The selection included original clinical studies (randomized controlled trials, cohort studies, systematic reviews, and meta-analyses) that assess the efficacy and safety of anti-VEGF drugs in patients with neovascular AMD. Results: A comparative analysis of anti-VEGF drugs, including Ranibizumab, Aflibercept, Bevacizumab, Faricimab, and Brolucizumab, was performed. Differences in mechanisms of action, duration of therapeutic effects, injection frequency, and safety profiles were noted. Various dosing regimens optimizing injection frequency were reviewed. Potential risks of anti-VEGF therapy, including intraocular inflammation, retinal vasculitis (most commonly associated with Brolucizumab), and systemic adverse effects, were identified. Conclusion: Anti-VEGF therapy remains the primary treatment method for neovascular AMD, ensuring disease stabilization and preservation of visual function. Modern drugs demonstrate high efficacy but differ in pharmacokinetic properties and safety profiles, necessitating an individualized approach to therapy.