Practice patterns for neovascular age-related macular degeneration (nAMD) have evolved from the landmark registration trials of vascular endothelial growth factor (VEGF) inhibitors. Non-monthly regimens like treat-and-extend (T&E) have become popular due to their effectiveness in clinical practice. T&E regimens attempt to limit the burden of visits and treatments by allowing progressively longer treatment intervals, but in so doing, are potentially associated with the expense of treating quiescent disease. This is acceptable to many patients and their ophthalmologists but can still be problematic in the real-world. Recent studies have further refined the T&E approach by allowing for quicker and longer extension of treatment intervals when less severe disease is detected. With newer drugs offering increased durability, a shift to longer regular intervals may emerge as a new practice pattern for VEGF inhibitor therapy. This review aims to consolidate the current literature on the most effective treatment patterns and update treatment guidelines based on options that are now available. It also summarises new aspects of nAMD management that may help to further refine current practice.
摘要: 新生血管性年龄相关性黄斑变性(nAMD)的治疗模式已从具有里程碑意义的血管内皮生长因子 (VEGF) 抑制剂注册试验中进行转变。治疗并延长方案(T&E)等非每月治疗方案因其在临床实践中的有效性而被广泛应用。T&E方案旨在通过逐渐延长治疗间隔来减轻就诊和治疗的负担, 但可能增加静止期疾病的治疗费用。这对许多患者及眼科医生来说可以接受, 但在真实世界中实施仍存在困难。最近的研究进一步完善了T&E方案, 当检测到病情较轻时, 可以更快、更长地延长治疗间隔。随着新药物提供了更高的持久性, 转向更长的规律间隔将成为VEGF抑制剂治疗的新的临床模式。本文旨在综合目前关于有效治疗模式的文献, 并根据现有的有效方案更新治疗指南。本文还总结了nAMD管理的新的进展, 有助于进一步完善当前的临床实践。.
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