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

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.