Treat-and-Extend Regimens With Anti-Vegf Agents in Retinal Diseases

Abstract

It is hoped that this practical review and TER algorithm will be of benefit to health care professionals interested in the management of retinal diseases.

Spectral-Domain Optical Coherence Tomography-Driven Treat-and-Extend and Pro Re Nata Regimen in Patients with Macular Oedema due to Retinal Vein Occlusion: 24-Month Evaluation and Outcome Predictors

“…A titration of the maximum recurrence-free treatment interval (RFTI) and finally the treatment in this time interval is aimed. The goal is the complete suppression of activity of oedema while minimizing the control and treatment costs [13]. To the best of our knowledge, besides a recent case series of 12 patients with CME due to CRVO being treated with ranibizumab using a modified TER, there are no further reports on the efficiency of a ranibizumab TER in RVO [15].…”

“…For other diseases treated with intravitreal anti-VEGF drugs, such as wet age-related macular degeneration (wAMD), this is already a common treatment scheme particularly in the US [13]. TER is an individualized treatment strategy based on the clinical experience that recurrences of CME occur at regular intervals, which has at least been proven for wAMD [14].…”

The Dilemma between the Randomized Control Trials and Real Life Practice in the Treatment of Retinal Diseases with Intravitreal anti-VEGF agents

“…We were able to call our patients for monthly visits and check for activity criteria of decrease in visual acuity, new hemorrhage, persistence of sub/intraretinal fluid etc., and when 1 or more activity criteria were present, injection was administered. However, it was realized that real-life experience was not similar to facts presented in prospective studies (4). Monthly visits were not always observed and injection numbers were dramatically lower.…”

“…In recent years, intravitreal anti-vascular endothelial growth factor (VEGF) agents have become the most important adjuncts to the treatment of retinal diseases, such as neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), and macular edema secondary to retinal vein occlusions (RVO) (1)(2)(3)(4)(5).…”

Aflibercept in persistent neovascular AMD: comparison of different treatment strategies in switching therapy

“…In the assessment of the final results of this study, we considered the current assertion that evaluation of the outcomes has to be guided by anatomical measure data with visual changes as a secondary guide. 2 Thus, patients in the PRN group lost a median of 3 ETDRS letters and the CRT decreased significantly to a median of 252 μm, a value considered within normal limits. 3 In contrast, patients in the fixed regimen gained a median of 3 ETDRS letters and the CRT significantly decreased to a median of 332 μm.…”