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Lotus Eye Hospital and Institute, Coimabtore, TN, India DOI : 10.37845/ret.vit.2025.34.36 Anti?vascular endothelial growth factor (anti-VEGF) therapy has transformed the management of retinal vascular and neovascular diseases, including neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), retinal vein occlusions (RVO), and myopic choroidal neovascularization (CNV). [1] These conditions are among the leading causes of irreversible visual impairment worldwide. Although originator anti-VEGF biologics have demonstrated robust efficacy and safety, their high cost, need for repeated intravitreal injections, and long-term treatment burden present significant challenges to patients and healthcare systems. These limitations are particularly relevant in the context of aging populations, the global diabetes epidemic, and increasing demand for retinal services. Biosimilar anti-VEGF agents have emerged as cost-effective alternatives developed to be highly similar to reference biologics in terms of structure, function, efficacy, safety, and immunogenicity. [2] This review provides a comprehensive overview of biosimilar anti-VEGF therapy for retinal diseases, including the scientific principles underlying biosimilar development, global regulatory pathways, currently available and emerging biosimilar agents, clinical evidence across major retinal indications, safety and immunogenicity considerations, real-world experience including switching studies, economic implications, and future perspectives. Keywords : Biosimilar: Anti-VEGF: Ranibizumab: Bevacizumab: Aflibercept 2mg