Tissue and Vascular Responses in Hypertensive Retinopathy with Monoclonal Antibodies as Antiangiogenic Therapy

Abstract

<em><strong>Objective</strong><em> to identify the ophthalmic use of monoclonal antibodies in hypertensive retinopathy and their effect on visual acuity (VA), vascular angiogenesis and changes in the ocular fundus of hypertensive patients. <em><strong>Materials and methods</strong><em> Literature was reviewed in the Pubmed, Medline, Embasi, Lilacs, The Cochrane Controlled Trials Register, Hinari, Micromedex and Science Direct databases, through the MESH terms <em>monoclonal antibody and hypertensive retinopathy</em>, <em>bevacizumab hypertensive retinopathy, monoclonal antibody therapy hypertensive retinopathy and pegaptanib and hypertensive retinopathy</em>, limited to years 2000 to 2012. Two thousand three hundred and forty-five (2345) studies were found related to the topic, among which those written in English, French, Portuguese and Spanish were selected, as well as those associated with efficacy in the treatment of hypertensive retinopathy and angiogenic changes in diabetic retinopathy. The quality of the scientific evidence was classified through the Oxford methodology. A descriptive analysis of the study variables related to tissue responses was conducted. Monoclonal antibodies are involved in the control of VEGF, which decrease the risk of retinal hemorrhages, reducing retinal thickness. Antibodies such as bevacizumab show 95% effectiveness for improvement in VA (ETDRS 3 Lines D.E. 2.15) while ranibizumab and pegaptanib have 86% in VA improvement (<em>p</em> <0.05). Triamcinolone shows improvement in vascular leakage and macular edema in hypertensive retinopathy associated with diabetes, without any significant differences between groups (<em>p</em>=0.03).