Anti-Vascular Endothelial Growth Factor Treatment Strategies for Neovascular Age-Related Macular Degeneration

Abstract

Vascular endothelial growth factor-A (VEGF-A) has been implicated as the major angiogenic stimulus responsible for neovascularisation in neovascular age-related macular degeneration. The past decade has been one of great progress for the treatment of neovascular age-related macular degeneration (AMD). Pharmacotherapy against VEGF - A have been introduced to treat neovascular AMD. Ranibizumab at the moment appears to be the most effective approved treatment for neovascular AMD. The benefits of intravitreal ranibizumab apply to all angiographic subtypes of neovascular AMD when the drug is injected at monthly intervals as shown ANCHOR and MARINA study. Treatment initiation with three consecutive monthly injections, followed by continued monthly injections, has provided the best visual acuity outcomes in pivotal cliniveal trials. If continued monthly injections are not feasible after initiation, a flexible strategy appears viable, with monthly monitoring of lesion activity recommended. Initiation regimens of fewer than three injections have not been assessed. Continuous careful monitoring with flexible treatment may help avoid vision loss recurring. The aim of this study was to analyse results of flexible anti-VEGF treatment in neovascular age-related macular degeneration, and to search for parameters with impact on outcome. © 2012 OMU.