Current and Emerging Anti-VEGF Therapy Dosing Regimens for nAMD and DME


Iqbal was only 32 years old when he had his first, and rather sudden, experience with diabetic eye disease. While at work, he experienced a sudden flash of light that left what he described as a fingerprint in the middle of his vision in one eye. Although it got better by the day, it limited everything he could do, from reading to driving. He eventually took the advice of his coworkers and scheduled a visit with an ophthalmologist who examined the back of his eye. Iqbal was certain he was injured at work (where he works daily with lasers and laser-based sensors). He was ready to file a claim for workers’ compensation, but his doctor was not too sure about that as he delivered his verdict. He noted that his eye was not hit or damaged by a laser at work, but his diabetes was the culprit.  

Iqbal was initially in disbelief. He protested that he prided himself on his command and control over his diabetes. He was equipped with all the latest technology, including an insulin pump, continuous glucose monitor, and labs proving spectacular HbA1c control over the past decade. However, his doctor had to tell him the bitter truth. While blood sugar control is essential for optimized health in a patient with diabetes, having spectacularly controlled diabetes is still not the same as not having diabetes at all. Iqbal was diagnosed with Type 1 diabetes at the tender young age of 4 years. His doctor reminded him that he has had nearly 3 decades of exposure to the disease, and the effects on the eye are cumulative. 

Diabetic macular edema is a common complication of diabetic retinopathy. Diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD) are both leading causes of blindness worldwide. However, the advent of anti-VEGF therapy has changed outcomes for many patients, allowing them to preserve vision for longer and some may experience a reversal of vision loss. Unfortunately, these medications, transformative as they are, carry their own burden as intravitreal injections that can be unpleasant and uncomfortable for patients. Yet, to maintain their vision, they are required to keep their monthly appointments and endure the frequent injections. A lapse in scheduling may mean a loss of visual acuity. But lapses in schedules happen, either due to competing healthcare visits, planned vacations, work, family commitments, or anything else.  

Because of this, doctors and researchers have devised multiple ways of reducing the treatment burden, but none were without their pros and cons. These included “as needed” (“PRN”) therapy, “treat-and-extend” therapy, and utilizing machine learning to predict a patient’s dosing interval. More recently, innovations in drug development, dosing strategies, and technology are addressing this need, with a few recent approvals. Find out more about how you can integrate these new strategies into your practice to help reduce the treatment burden in your patients with DME and nAMD and preserve their vision. 

As for Iqbal, his vision improved over the next 2 weeks until it was back to normal, but he is now acutely aware of the disease process progressing at the back of his eyes. Taking care of his diabetes is no longer confined to monitoring his blood sugar and meeting with his endocrinologist, seeing his ophthalmologist regularly has become part of the routine.  

For more, check out the following CE activities below!
Taking Stock of Current and Emerging Anti-VEGF Therapy Dosing Regimens for nAMD
Evolving Strategies to Ease the Burden Related to the Treatment of nAMD
Easing the Burden of Retinal Diseases: A Focus on the Optimal Application of Intravitreal Therapy in DME and nAMD

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Taking Stock of Current and Emerging Anti-VEGF Therapy Dosing Regimens for nAMD