To provide guidance on the management of patients with neovascular age-related macular degeneration
and its subtypes who respond poorly to anti–vascular endothelial growth factor (anti-VEGF
) therapy, and to identify cases where suspending anti-VEGF
treatment may be warranted.
Through a literature review and the combined knowledge and clinical experience of retinal experts, the Steering Committee of the Bayer-sponsored Vision Academy
developed an algorithm for determining when to suspend anti-VEGF
treatment of neovascular age-related macular degeneration
in cases of futility.
Consideration of factors that may cause suboptimal response to anti-VEGF
therapy, such as undertreatment or misdiagnosis of the underlying condition, and factors that may preclude continued treatment, such as injection- or drug-induced complications, is necessary for adjusting treatment protocols in patients who respond poorly to anti-VEGF
. If poor response to treatment persists after switching to an alternative anti-VEGF
agent and no change in response is observed after withholding treatment for a predetermined period of time (“treatment pause”), anti-VEGF
treatment may be considered futile and should be suspended.
This publication introduces an algorithm to guide the management of neovascular age-related macular degeneration
in patients showing poor response to anti-VEGF
treatment and provides expert guidance for suspending anti-VEGF
treatment in cases of futility.