Purpose of review: This report reviews the current treatment strategies and ongoing clinical trials in the treatment of neovascular age-related macular degeneration (AMD).
Recent findings: The functional and anatomic outcomes achieved in the pivotal ranibizumab trials with monthly injections set the standard for comparison. Since then, various modified dosing regimens with the aim of lessening the treatment burden associated with monthly injections have been investigated. Combination therapy incorporating photodynamic therapy and antivascular endothelial growth factor (anti-VEGF) therapy may represent an alternative treatment approach and randomized multicenter clinical trials are ongoing. In addition, new pharmacologic agents like VEGF Trap-Eye are being developed and investigated; preliminary 1-year results with VEGF Trap-Eye are encouraging.
Summary: Ranibizumab or bevacizumab monotherapy remains the preferred therapy in the management of neovascular AMD at the present time. Ongoing clinical trials will help determine the efficacy of ranibizumab relative to bevacizumab, evaluate the long-term efficacy and safety of combination therapy modalities, and assess the role of new pharmacologic agents.