Anti-VEGF agents in the treatment of neovascular AMD

Treatment of neovascular age-related macular degeneration (AMD) has advanced rapidly with the recent introduction into clinical practice of several agents that block vascular endothelial growth factor (VEGF). Pegaptanib, bevacizumab and ranibizumab have been shown to alter the course of disease of exudative AMD. In the case of ranibizumab or bevacizumab, the change can be dramatic. Agents directed against the action of VEGF are most typically injected directly into the vitreous and must be delivered frequently, perhaps as often as every 4–6 weeks. Further refinement of treatment parameters via individually guided therapy using clinical examinations and diagnostic testing, such as optical coherence tomography, may decrease the necessary frequency of anti-VEGF therapy in wet AMD. Combination therapy using anti-VEGF treatments in conjunction with photodynamic therapy with verteporfin may also potentially decrease the frequency of treatment.