Plasma rich in growth factors as a treatment for ocular fundus diseases: Mapping current applications and future directions

Posterior segment diseases are a leading cause of irreversible blindness and remain challenging to treat with current therapies. Blood-derived products have emerged as promising regenerative tools due to their anti-inflammatory, neuroprotective, and regenerative properties. This review synthesizes evidence from 46 clinical studies published between 2019 and 2025, covering 1253 patients and 1570 eyes treated with platelet-rich derivatives for ocular fundus diseases. The most frequent indications were structural defects (59 %), inherited retinal dystrophies (11 %), optic neuropathies (11 %), age-related macular degeneration (7 %), and vascular dysfunctions (5 %). These therapies were administered via various routes, including intravitreal, subtenon, suprachoroidal, and subretinal injections, as well as eye drops and fibrin membranes. Across pathologies, platelet-derived therapies demonstrated high anatomical success rates, functional improvements, and low incidence of adverse events, most of which were transient and mild. Among the different formulations, plasma rich in growth factors (PRGF-Endoret®) stood out for its standardized preparation, immunosafe profile, and versatility in application. Despite promising clinical outcomes, heterogeneity in study designs, small sample sizes, and lack of standardized protocols limit generalizability. Further randomized controlled trials and mechanistic studies are needed to validate efficacy, define optimal formulations, and identify the patient populations most likely to benefit. Blood-derived products represent a promising therapeutic avenue in regenerative ophthalmology and may serve as effective adjuncts or alternatives in managing complex retinal and optic nerve disorders.