Achievements and challenges of current anti-VEGF therapy

Dermot McGrath

Posted: Friday, September 21, 2018

Anti-VEGF agents have revolutionised the treatment of neovascular age-related macular degeneration, significantly reducing AMD-associated blindness and visual impairment in the process, according to Ursula Schmidt-Erfurth MD, PhD, at a special session on the EURETINA Guidelines for Management of Retinal Disease yesterday.
Highlighting the achievements and challenges of current anti-VEGF therapy, Dr Schmidt-Erfurth said that intravitreal anti-VEGF therapy has significantly reduced the risk of vision loss in the major retinal diseases.
“A miracle happens when we treat with a simple injection of anti-VEGF because a retina can become perfectly normal with this treatment. We know that anti VEGF therapy is beneficial for patients with a rapid, significant and maintained increase in vision and it is also beneficial for the economy given the massive investments involved,” she said.
While there has been a significant improvement in therapeutic approaches to the treatment of exudative AMD in recent years, she noted that the impressive benefit of antiangiogenic therapy has not always carried over into real-world scenarios, with outcomes consistently less favourable than clinical trial results.
Clinical trials have evaluated fixed one-, two- and three-monthly regimens and flexible PRN and treat-and-extend strategies, noted Dr Schmidt-Erfurth.
“Many different approaches and strategies have been tried to bridge this gap between clinical trial data and real-world outcomes but the jury is still out on the optimal number to go before the monthly regimens. No decision has been made yet and there is a request for a global consensus on real world outcome measures to allow greater comparison of results. But this consensus has not been reached yet,” she said.