Antivascular endothelial growth factor therapies for neovascular age-related macular degeneration: Search for the optimized treatment regimen

Age-related macular degeneration is the leading cause of irreversible visual loss in elderly patients. After photodynamic therapy, therapy targeting vascular endothelial growth factor (VEGF) therapy has become the gold standard for treating neovascular age-related macular degeneration. Although monthly intravitreal injections of anti-VEGF agents are the most promising treatment to improve and sustain vision, as-needed treatments were administered based on the monthly examinations mainly because of cost-effectiveness. However, as-needed treatments are considered reactive treatments that burden patients and doctors with required monthly examinations and potentially decrease the improved vision. To address this, the treat-and-extend regimen, a proactive treatment, has been advocated as individualized medicine. This article reviews the characteristics of currently available anti-VEGF agents and treatment strategies.