Preferred therapies for neovascular age-related macular degeneration

Abstract

Purpose of review: This report reviews the current treatment strategies and the most recent clinical trials in the treatment of neovascular age-related macular degeneration.

Recent findings: The functional and anatomic outcomes achieved in the pivotal ranibizumab trials with monthly injections set the standard for comparison. Since then, various modified dosing regimens with the aim of lessening the treatment burden associated with monthly injections have been investigated. Additionally, level I evidence now exists for the noninferiority of bevacizumab, as compared to ranibizumab, in the treatment of neovascular age-related macular degeneration (AMD) through 1 year of follow-up. Aflibercept has emerged as a new anti- vascular endothelial growth factor (VEGF) therapy showing encouraging treatment results at 1 year. Novel treatments combined with anti-VEGF agents such as localized radiation are currently being investigated.

Summary: Anti-VEGF monotherapy remains the preferred therapy for the management of neovascular AMD at the present time. Aflibercept is a new, FDA-approved, effective, anti-VEGF agent available for clinical use. Ongoing clinical trials will help determine the optimal dosing regimens for all of these agents, as well as the long-term efficacy and safety of combination therapy modalities.