March 3, 2017 Conference
Neovascular Age-related Macular Degeneration: Best Practices and Optimal Dosing for Anti-VEGF
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Dr. Joan Miller, Massachusetts Eye and Ear Infirmary (Presenter)
Speaker Session Topic
Anti-VEGF therapy changed the paradigm and expectations for neovascular AMD treatment. In managing patients with neovascular AMD, clinicians need to choose diagnostic imaging and testing, initial therapeutic agent, and treatment regimen; and in follow-up, whether and when to switch drugs. Available data from AMD clinical trials do not support a best practice in drug choice or treatment protocol, and drug selection may be affected by coverage benefit, concerns about compounding pharmacies and provider past experience. The rationale for switching agents is even less well developed. There is currently no best practice standard, although meta-analyses suggest that clinicians “under-treat” in the first few years. Longer-term findings demonstrate progressive vision loss and GA, most likely due to unveiling of the degenerative process when neovascular disease is controlled. Future directions for treatment of neovascular AMD should include neuroprotection as adjuvant therapy.