Individualized treatment with aflibercept in age-related macular degeneration patients with early persistent retinal fluid
Age-related macular degeneration (AMD) is one of the leading causes of blindness among the elderly (1). Currently, there is no cure for the disease; however, intravitreal anti vascular endothelial growth factor (anti-VEGF) agents have significantly improved visual outcomes in patients with neovascular age-related macular degeneration (nAMD) (2-5). Ranibizumab was approved for the treatment of exudative AMD based on results from two phase III trials: ANCHOR (patients with predominantly classic choroidal neovascularisation) and MARINA (patients with minimally classic or occult choroidal neovascularisation) (2,3). Several subsequent studies showed that the best visual outcomes were achieved in these initial clinical trials, where monthly injections of anti-VEGF were applied (6). However, this regimen was not commonly followed outside clinical trials due to the high costs and level of care associated with a fixed treatment regimen, together with the possibility of administering unnecessary treatments to some patients (7). Consequently, the search for other drugs and/or treatment patterns that maintain efficiency by reducing the number of injections and visits has been the main objective of research in nAMD.