Neovascular Age-Related Macular Degeneration Management
Summary
Neovascular age-related macular degeneration (nAMD) is marked by abnormal choroidal new vessel growth beneath the macula, leading to fluid exudation, haemorrhage and rapid central vision loss. Management pivots on early detection, precise imaging and sustained suppression of pathological angiogenesis. Intravitreal inhibitors of vascular endothelial growth factor (VEGF) have transformed the prognosis of nAMD, yet optimal regimens strive to balance visual gains against treatment burden and potential adverse events. Clinicians employ fixed dosing, pro re nata (PRN) monitoring and treat-and-extend protocols, using optical coherence tomography and functional acuity measurements to guide personalised care. Recent innovations target complementary pathways such as angiopoietin-2 to enhance durability, while refinements in imaging and dosing algorithms aim to reduce injection frequency without compromising long-term visual outcomes.
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Neovascular Age-Related Macular Degeneration Management publication trend
The graph below shows the total number of articles in neovascular age-related macular degeneration management across all publications each year (not limited to Nature Index journals).
Technical terms
Neovascularization: Pathological formation of new blood vessels in the choroid that infiltrate the macula.
Anti-VEGF therapy: Intravitreal administration of agents that inhibit vascular endothelial growth factor to reduce angiogenesis and fluid leakage.
Treat-and-extend regimen: A personalised dosing strategy in which injection intervals are lengthened or shortened based on disease activity assessed at each visit.
Bispecific antibody: An engineered immunoglobulin capable of simultaneously binding two distinct molecular targets to enhance therapeutic effect.
Best-corrected visual acuity (BCVA): The highest level of visual clarity achievable with optimal refractive correction, measured in standardised letters or charts.
Optical coherence tomography (OCT): Non-invasive imaging technology that provides cross-sectional views of retinal structures and fluid compartments.
References
- Aflibercept is more effective than bevacizumab at weaning neovascular age-related macular degeneration patients off therapy. Journal of Clinical Investigation (2023).
- TENAYA and LUCERNE Two-Year Results from the Phase 3 Neovascular Age-Related Macular Degeneration Trials of Faricimab with Treat-and-Extend Dosing in Year 2. Ophthalmology (2024).
- Fundamental principles of an anti-VEGF treatment regimen: optimal application of intravitreal anti–vascular endothelial growth factor therapy of macular diseases. Graefe's Archive for Clinical and Experimental Ophthalmology (2017).
- The real-world efficacy and safety of faricimab in neovascular age-related macular degeneration: the TRUCKEE study – 6 month results. Eye (2023).
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