Abstract: Retinal ischemia is one of complications of diabetic retinopathy (DR), commonly evaluated by retinal nonperfusion area (RNP) which has a strong relationship with high expression of vascular endothelial growth factor (VEGF) in the process of DR. Previous studies found that VEGF played an important role in endothelial cell hypertrophy, leukocyte plugging in the development of retinal vessel closure, while RNP could be successfully improved after anti-VEGF treatment. However, many clinical data showed that anti-VEGF treatment was incapable of stopping the progression of RNP. Besides, the studies based on OCTA demonstrated that anti-VEGF contributed to retinal reperfusion, but the effect on intraretinal microvascular abnormalities (IRMA ) and RNP around showed different results: RNP could be reperfused, stable or deteriorated. Further studies about the mechanism of anti-VEGF on RNP deterioration are still needed for stopping even reversing retinal ischemia and RNP in DR. (Int Rev Ophthalmol, 2022, 46: 1-4)

Key words: diabetic retinopathy, retinal ischemia, anti-VEGF therapy