Intravitreal anti-VEGF injections rapidly regress neovascularization and improve surgical conditions, but are temporizing unless combined with panretinal photocoagulation (PRP) or other ischemia-directed therapies.<h4>Conclusions and future directions</h4>Long-term success in NVG patients requires integrated, individualized care that couples antiangiogenic bridging, durable management of retinal ischemia, and optimized surgical strategies. This evidence concerns the gene VEGFA and ischemia.