Current and upcoming anti-VEGF therapies and dosing strategies for the treatment of neovascular AMD: a comparative review

Abstract

Age-related macular degeneration is the leading cause of vision loss in the developed world, with the expected number of affected elderly individuals reaching 17.8 million. Antivascular endothelial growth factor (anti-VEGF) injection therapy has been instrumental in treating a disease process that was previously thought to be untreatable. Over the past two decades, landmark studies have demonstrated the efficacy of different anti-VEGF medications and investigated the optimal dosing regimen and delivery mechanism to increase overall vision and minimise patient burden. In this review, we outline landmark neovascular age-related macular degeneration clinical trials that have demonstrated level 1 evidence for its usage or have contributed to the understanding of how to dose these agents.

Keywords: Macula; Retina; Treatment Medical.

Figure 1

The figure explores the relationship between the number of injections and the number of ETDRS letters gained. Even though the agents have different durability, there is a positive and clinically meaningful correlation. Only FDA registration and National Eye Institute trials were included in this analysis (bolded in table 1). Brolucizumab 3 mg dose is the triangle data point in the figure. BCVA, best corrected visual acuity; ETDRS, early treatment of diabetic retinopathy; FDA, Food and Drug Administration.