Retinal angiogenesis and choroidal angiogenesis are major causes of vision loss, and the pathogenesis of this angiogenesis process is still uncertain. However, several key steps of the angiogenic cascade have been elucidated. In retinal angiogenesis, hypoxia is the initial stimulus that causes up regulation of growth factors, integrins and proteinases, which result in endothelial cell proliferation and migration that are critical steps in this process. Once the endothelial tube is formed from the existing blood vessels, maturation starts with recruitment of mural cell precursors and formation of the basement membrane. Normally, there is a tight balance between angiogenic factors and endogenous angiogenesis inhibitors that help to keep the angiogenic process under control. Although the steps of choroidal angiogenesis seem to be similar to those of retinal angiogenesis, there are some major differences between these two processes. Several anti-angiogenic approaches are being developed in animal models to prevent ocular angiogenesis by blocking the key steps of the angiogenic cascade. Based on these pre-clinical studies, several anti-angiogenic clinical trials are ongoing in patients with diabetic retinopathy and age-related macular degeneration. This review discusses the pathogenesis of retinal and choroidal angiogenesis, and alternative pharmacological approaches to inhibit angiogenesis in ocular diseases.

中文翻译：

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视网膜和脉络膜血管生成：病理生理学和抑制策略。

视网膜血管生成和脉络膜血管生成是视力丧失的主要原因，并且这种血管生成过程的发病机理仍不确定。但是，已经阐明了血管生成级联反应的几个关键步骤。在视网膜血管生成中，缺氧是引起生长因子，整联蛋白和蛋白酶上调的初始刺激，从而导致内皮细胞增殖和迁移，这是该过程的关键步骤。一旦从现有血管中形成内皮管，成熟就从壁细胞前体的募集和基底膜的形成开始。通常，血管生成因子与内源性血管生成抑制剂之间存在紧密的平衡，有助于保持血管生成过程的可控性。尽管脉络膜血管生成的步骤似乎与视网膜血管生成的步骤相似，但是这两个过程之间存在一些主要差异。在动物模型中，正在开发几种抗血管生成方法，以通过阻止血管生成级联反应的关键步骤来预防眼部血管生成。基于这些临床前研究，正在对糖尿病性视网膜病变和年龄相关性黄斑变性的患者进行多项抗血管生成临床试验。这篇综述讨论了视网膜和脉络膜血管生成的发病机理，以及抑制眼部疾病血管生成的替代药理方法。在动物模型中，正在开发几种抗血管生成方法，以通过阻止血管生成级联反应的关键步骤来预防眼部血管生成。基于这些临床前研究，正在对糖尿病性视网膜病和年龄相关性黄斑变性的患者进行多项抗血管生成临床试验。这篇综述讨论了视网膜和脉络膜血管生成的发病机理，以及抑制眼部疾病血管生成的替代药理方法。在动物模型中，正在开发几种抗血管生成方法，以通过阻止血管生成级联反应的关键步骤来预防眼部血管生成。基于这些临床前研究，正在对糖尿病性视网膜病变和年龄相关性黄斑变性的患者进行多项抗血管生成临床试验。这篇综述讨论了视网膜和脉络膜血管生成的发病机理，以及抑制眼部疾病血管生成的替代药理方法。