Neovascular age-related macular degeneration at treatment intervals of 14 weeks or greater

Clin Exp Ophthalmol. 2021 Aug;49(6):570-578. doi: 10.1111/ceo.13962. Epub 2021 Jul 14.


Background: We assessed the proportion of eyes with neovascular age-related macular degeneration (nAMD) in routine clinical practice that reach ≥14 week treatment intervals and their outcomes.

Method: We analysed data from the Fight Retinal Blindness! (FRB!) Project database, a prospectively designed registry of 'real-world' outcomes. Treatment-naive eyes starting vascular endothelial growth factor (VEGF) inhibitors for nAMD from 1st January 2006 were included. Eyes were defined to have reached the ≥14 week treatment interval if they received ≥2 consecutive injections at treatment intervals of ≥14 week but not exceeding 26 weeks. Outcomes were reported in a subgroup of eyes that had 12 months of follow-up from reaching this interval.

Results: Of the 3907 treatment-naïve eyes that started treatment during the identified periods on a treat-and-extend regimen and received at least 8 injections over the first 2 years, 402 (10%) eyes received at least 2 consecutive injections at an interval of ≥14 week during their follow-up. Fifty-two percent of these eyes maintained vision to 12 months, however only 40% stayed at this interval and 25% of the lesions reactivated.

Conclusion: We found that only 10% of eyes with nAMD were extended beyond a 13-week injection interval and that over half had returned to a shorter interval by 12 months. Eyes that stayed at this extended treatment interval maintained stable vision. More data on the outcomes of eyes treated with intervals longer than 3 months are required to establish whether emerging VEGF inhibitors provide a more sustained effect than the currently available drugs.

Keywords: anti-vascular endothelial growth factor; neovascular age-related macular degeneration; treatment interval.

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Humans
  • Intravitreal Injections
  • Macular Degeneration* / drug therapy
  • Ranibizumab / therapeutic use
  • Retrospective Studies
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A
  • Visual Acuity
  • Wet Macular Degeneration* / diagnosis
  • Wet Macular Degeneration* / drug therapy


  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Ranibizumab