Treat-and-extend regimen for management of neovascular agerelated macular degeneration: recommendations from the Hong Kong Retina Expert Panel

Ian YH Wong, Danny SC Ng, Nicholas SK Fung, Yvonne Chan, Derek CY Chung, Mary Ho, Callie KL Ko, Joy WY Leung, Shaheeda Mohammed, Helena PY Sin, Heather HY Tang, Raymond LM Wong, Timothy YY Lai

Abstract


Antivascular endothelial growth factor (anti-VEGF) agents are a safe and effective treatment option for neovascular age-related macular degeneration (nAMD). However, undertreatment related to the costs and route of administration of anti-VEGF agents remains a common problem for nAMD patients. The treat-and-extend (T&E) regimen for nAMD has proven to balance clinical effectivity with reduced numbers of injections. However, implementation of the T&E regimen depends on the capacity and resources of clinics and patient compliance. To determine the optimal T&E regimen for Hong Kong, a panel of retina specialists was initiated by MediPaper Medical Communications Limited to discuss the benefits and hurdles in adopting the T&E regimen and to develop recommendations for patient selection based on clinical needs, dosing criteria, and dosing regimen. Key recommendations included selecting patients with only-eye or recurrence for the T&E regimen, pre-booking clinic appointments to reduce patient visits, communicating the T&E regimen with non-vitreoretinal physicians and trainees, extending the maximum dose interval to 16 weeks, and actively engaging patients in decision making.


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