Faricimab-svoa (Vabysmo – Genentech), an inhibitor of both vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2), has been approved by the FDA for intravitreal treatment of neovascular (wet) age-related macular degeneration (nAMD) and diabetic macular edema (DME). It is the first drug to become available in the US that targets two pathways involved in maintaining vascular homeostasis. Several VEGF inhibitors are available for treatment of nAMD and DME (see Table 2).

Vascular endothelial growth factor (VEGF) is a principal mediator of neovascularization in wet age-related macular degeneration (AMD) and diabetic macular edema. It induces angiogenesis and increases vascular permeability and inflammation. VEGF inhibitors reduce leakage from blood vessels, prevent proliferation of new abnormal vessels, decrease swelling of the retina, and improve visual acuity in patients with neovascular (wet) AMD and diabetic macular edema. These drugs are given as periodic intravitreal injections with topical anesthesia.

The FDA has authorized use of the Valeda Light Delivery System (LumiThera), a multiwavelength photobiomodulation (PBM) device, to improve visual acuity in patients with dry age-related macular degeneration (AMD) who have best-corrected visual acuity (BCVA) of 20/32 to 20/70.

The FDA has approved Susvimo (Genentech), a refillable permanent ocular implant containing the vascular endothelial growth factor (VEGF) inhibitor ranibizumab, for treatment of neovascular (wet) age-related macular degeneration (nAMD) in patients who have previously responded to at least two intravitreal injections of a VEGF inhibitor. Ranibizumab intravitreal injection (Lucentis) has been available since 2006 for monthly treatment of nAMD. The FDA has approved ranibizumab-nuna (Byooviz), a biosimilar of Lucentis and the first ophthalmologic biosimilar; it will be available in June...

The FDA has approved the complement C3 inhibitor pegcetacoplan (Syfovre – Apellis) for treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Given as a series of monthly or every-other-month (EOM) intravitreal injections, it is the first drug to become available for use in patients with atrophic dry AMD. Subcutaneous pegcetacoplan was approved earlier as Empaveli for treatment of paroxysmal nocturnal hemoglobinuria.

The FDA has approved the complement C5 inhibitor avacincaptad pegol (Izervay – Iveric) for intravitreal treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Avacincaptad pegol is the second complement inhibitor to be approved in the US for this indication; pegcetacoplan (Syfovre), a complement C3 and C3b inhibitor, was approved earlier.

This issue includes reviews of drugs for glaucoma, age-related macular degeneration (AMD), bacterial conjunctivitis, and dry eye disease. Allergic conjunctivitis is reviewed in a separate issue.

Eylea HD (Regeneron), which contains 8 mg of the vascular endothelial growth factor (VEGF) inhibitor aflibercept, has now been approved by the FDA for intravitreal treatment of macular edema following retinal vein occlusion (RVO). A 2-mg dose of aflibercept (Eylea) was approved previously for this indication. Eylea and Eylea HD are also approved for treatment of neovascular (wet) age-related macular degeneration, diabetic macular edema, and diabetic retinopathy.

Ziv-aflibercept (Zaltrap – Sanofi/Regeneron), a vascular endothelial growth factor (VEGF) inhibitor, has been approved by the FDA for use in combination with 5-fluorouracil, leucovorin and irinotecan (FOLFIRI) for treatment of metastatic colorectal cancer that is resistant to or has progressed following an oxaliplatin-containing regimen. It is the same drug as aflibercept, which was approved last year as an intravitreal injection (Eylea) for treatment of neovascular (wet) agerelated macular degeneration (AMD). Ziv-aflibercept is the second VEGF inhibitor approved for treatment...

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