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Combination of **squalamine lactate**, a small molecule angiogenesis inhibitor formulated for topical ophthalmic use, and **ranibizumab**, a recombinant, humanized anti-VEGF monoclonal antibody fragment indicated for intravitreal injection. Squalamine lactate exerts its effect through intracellular inhibition of multiple angiogenic factors, including vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and basic fibroblast growth factor (bFGF), via displacement of calmodulin from endothelial cells, thus inhibiting neovascularization. Ranibizumab binds extracellular VEGF-A, preventing receptor activation and downstream angiogenic signaling. The combination aims to enhance visual outcomes in neovascular age-related macular degeneration (wet AMD), diabetic macular edema (DME), and macular edema secondary to retinal vein occlusion (RVO), seeking additive or synergistic inhibition of angiogenesis compared to monotherapy[1][2][3][4][5][6].
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