SUSPENDING TREATMENT OF NEOVASCULAR AGE-RELATED MACULAR DEGENERATION IN CASES OF FUTILITY.
| Autor: | Wong DT; University of Toronto, Toronto, ON, Canada.; St. Michael's Hospital, Toronto, ON, Canada., Lambrou GN; Global Medical Affairs Ophthalmology, Bayer, Switzerland., Loewenstein A; Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel., Pearce I; Royal Liverpool University Hospital, Liverpool, United Kingdom; and., Okada AA; Kyorin University School of Medicine, Tokyo, Japan. |
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| Jazyk: | angličtina |
| Zdroj: | Retina (Philadelphia, Pa.) [Retina] 2020 Jun; Vol. 40 (6), pp. 1010-1020. |
| DOI: | 10.1097/IAE.0000000000002713 |
| Abstrakt: | Purpose: To provide guidance on the management of patients with neovascular age-related macular degeneration and its subtypes who respond poorly to anti-vascular endothelial growth factor (anti-VEGF) therapy, and to identify cases where suspending anti-VEGF treatment may be warranted. Methods: Through a literature review and the combined knowledge and clinical experience of retinal experts, the Steering Committee of the Bayer-sponsored Vision Academy developed an algorithm for determining when to suspend anti-VEGF treatment of neovascular age-related macular degeneration in cases of futility. Results: Consideration of factors that may cause suboptimal response to anti-VEGF therapy, such as undertreatment or misdiagnosis of the underlying condition, and factors that may preclude continued treatment, such as injection- or drug-induced complications, is necessary for adjusting treatment protocols in patients who respond poorly to anti-VEGF. If poor response to treatment persists after switching to an alternative anti-VEGF agent and no change in response is observed after withholding treatment for a predetermined period of time ("treatment pause"), anti-VEGF treatment may be considered futile and should be suspended. Conclusion: This publication introduces an algorithm to guide the management of neovascular age-related macular degeneration in patients showing poor response to anti-VEGF treatment and provides expert guidance for suspending anti-VEGF treatment in cases of futility. |
| Databáze: | MEDLINE |
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