Recommendations of the treat-and-extend regimen for neovascular age-related macular degeneration: 2020 updates

Authors

  • Alvin KH Kwok Hong Kong Sanatorium & Hospital
  • Wai-Ching Lam Department of Ophthalmology, The University of Hong Kong
  • Angie HC Fong Hong Kong Eye Hospital
  • Nicholas SK Fung Department of Ophthalmology, The University of Hong Kong
  • Mary Ho Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital
  • Lawrence PL Iu Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital
  • Callie KL Ko Department of Ophthalmology, Tung Wah Eastern Hospital
  • Shaheeda Mohamed Hong Kong Eye Hospital
  • Danny SC Ng Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong
  • Heather HY Tang Department of Ophthalmology, United Christian Hospital
  • Ian YH Wong Hong Kong Sanatorium & Hospital
  • Raymond LM Wong Hong Kong C-MER Dennis Lam & Partners Eye Center
  • Timothy YY Lai Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong
  • CT Tsoi

Keywords:

Macular degeneration, Retina, Subretinal fluid

Abstract

Anti-vascular endothelial growth factor (anti-VEGF) treatment is the gold standard of care for neovascular age-related macular degeneration (nAMD). To strike a balance between treatment burden and vision improvement, a treat-and-extend (T&E) regimen is the preferred approach to administer anti-VEGF treatment.

To facilitate implementation of the T&E regimen for nAMD in Hong Kong, a panel of retinal experts, with the support of Bayer Healthcare, held an online meeting on 15 September 2020 to discuss the latest published evidence and clinical experiences regarding the suitability and safety of anti-VEGF agents in the T&E regimen, patient selection, retreatment criteria, considerations for treatment discontinuation, and barriers to implementing the T&E regimen.

Compared with the 2019 recommendations, this 2020 version contains several major updates including differentiation of fluid compartments in retreatment criteria, additional considerations for patient selection, streamlined criteria for treatment cessation, and applicability of the T&E regimen in patients with polypoidal choroidal vasculopathy (PCV).

These updated recommendations are expected to facilitate implementation of the T&E regimen for nAMD including PCV in Hong Kong, with the aims of improving patient visual acuity, lowering treatment burden, and facilitating service capacity planning over the long term.

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Published

2021-11-11

How to Cite

1.
Kwok AK, Lam W-C, Fong AH, Fung NS, Ho M, Iu LP, Ko CK, Mohamed S, Ng DS, Tang HH, Wong IY, Wong RL, Lai TY, Tsoi C. Recommendations of the treat-and-extend regimen for neovascular age-related macular degeneration: 2020 updates. Hong Kong J Ophthalmol [Internet]. 2021Nov.11 [cited 2021Dec.3];25(2). Available from: https://hkjo.hk/index.php/hkjo/article/view/306

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Review Articles