New Insights in Anti-VEGF Resistant Macular Edema
A special issue of Cells (ISSN 2073-4409). This special issue belongs to the section "Cellular Pathology".
Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 13773
Special Issue Editor
Special Issue Information
Dear Colleagues,
Anti-VEGF agents are not effective in all patients with retinal vascular conditions with macular edema, and this so-called anti-VEGF non-response is generally believed to be due to alternative causal pathways of inflammatory or unknown nature. As an alternative explanation, in a significant part of anti-VEGF non-responsive patients, retinal edema may be caused by highly localized focal vascular abnormalities such as Telcaps with a defective vascular wall, identified by ICG staining, which allows unrestricted plasma protein extravasation. The extravasation of plasma proteins such as lipoproteins, which normally cannot enter the retinal interstitium, leads to deposition of hard exudates, usually in a circinate pattern at the border of the retinal edema. In addition, these plasma proteins, which diffuse away from the focal leakage site through the retinal interstitium, may have an important role not only in retinal edema formation through the rules of Starling, but also in causing secondary inflammation which induces leakage of the ‘normal’ vasculature in the surrounding retina, and further edema formation. ICG-guided laser of microvascular abnormalities may be an effective treatment option in this edema, and, counterintuitively, macrophage influx induced by laser treatment may play an additional beneficial role in resolving edema by removal of the extravasated proteins.
Prof. Dr. Leonardo Mastropasqua
Guest Editor
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Keywords
- macular edema
- hard exudates
- blood-retinal barrier
- inflammation
- macrophages
