4.3 Article

Management of neovascular age-related macular degeneration: Taiwan expert consensus

Journal

JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION
Volume 120, Issue 12, Pages 2061-2071

Publisher

ELSEVIER TAIWAN
DOI: 10.1016/j.jfma.2021.06.012

Keywords

Neovascular age-related macular degeneration; Wet age-related macular degeneration; Vascular endothelial growth factors

Funding

  1. Full Universe Integrated Marketing Ltd., Taiwan - Novartis Taiwan

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The article provides recommendations on diagnosis, treatment, and follow-up strategies for neovascular age-related macular degeneration, focusing on comprehensive ophthalmologic examination, anti-VEGF therapy, treatment regimen selection and adjustment, and patient education.
Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible vision loss. The present consensus provides suggestions on diagnosis, evaluation, treatment, and follow-up strategies for nAMD from a panel of 11 practicing ophthalmologists. The experts suggest that the baseline visit for nAMD management should include a comprehensive ophthalmologic examination via a multimodal approach consisting of visual and anatomical evaluation. Patients diagnosed with nAMD should be subjected to treatment with the goal of maintaining visual function while diminishing anatomical disease activity and minimizing treatment burden. Currently, anti-VEGF therapy is the main treatment strategy for nAMD, and evaluation involving comprehensive ophthalmologic examination within 1 month of completion of the loading phase comprising three monthly injections is recommended to guide subsequent management. Either a treat-and-extend or pro re nata regimen can be considered for the maintenance phase of anti-VEGF therapy, and the regimen should be chosen and adjusted according to disease activity, reimbursement criteria, financial burden, and patient preferences. In the event of inactive nAMD or poor treatment outcomes, after thorough evaluation and patient education, anti-VEGF therapy may be stopped. The consensus provides practical nAMD management guidelines for ophthalmologists and fellow healthcare professionals. Copyright 2021, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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