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4 VEGFTrap
VEGF－trap由Regeneron药业和塞诺菲安万特联合研发，是一种特殊的抗血管生成物，VEGF－trap是人VEGF受体Flt1和KDR的细胞外区域部分与人免疫球蛋白G的Fe片段的结合体，阻止VEGF与Flt1和KDR的结合。
VEGF－trap与血液中VEGF之间的亲合力比单克隆抗体高100～1 000倍。目前主要应用于肿瘤领域（处于Ⅱ期临床阶段），最近很多研究试图将其用于AMD继发CNV的治疗。 Nguyen等[20]进行了VEGF－trapⅠ期临床试验，对21例渗出型AMD患者，分别给予玻璃体腔内一次性注射VEGF－trap（0.05～4mg），随访6mo，患者视力平均提高4.8个字母，视网膜黄斑平均厚度减少134μm。在他们随后进行的另一项的研究中，25例AMD继发CNV的患者随机分为两组，治疗组19例，给予静脉注射VEGFtrap，剂量分别为0.3mg/kg、1.0mg/kg、3.0 mg/kg；对照组6例给予假性注射。在试验中3.0mg/kg组因有2例分别出现了高血压与蛋白尿退出了本研究，结果显示,在注射后15d，对照组与0.3mg/kg、1.0mg/kg组的黄斑厚度分别减少12%、10%和66%(P<0.05)；第71d分别是5.6%、47.1% 和63.3%(P<0.05)，结果显示静脉注射该药物的最大有效剂量为1.0 mg/kg。目前该药的II临床研究还正在进行中。
综上所述，VEGF拮抗类药物能有效地抑制眼内新生血管形成，但其安全性、远期并发症还需要进一步大样本、长期的临床研究来验证。
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