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Room for improvement in anti-VEGF treatment of AMD, surgeon says
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LAS VEGAS — The advent of anti-VEGF agents has bolstered the fight against wet age-related macular degeneration, but several unanswered questions remain, according to a specialist speaking here.
George A. Williams, MD, Ocular Surgery News Retina/Vitreous Section Member, posed many of those questions in giving the retina keynote address at the OSN Las Vegas meeting. He also presented an overview of the U.S. clinical trials that are evaluating anti-VEGF agents for AMD.
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![George A. Williams, MD [photo]](images/osn/200605b/williams.jpg)
"Our new goal is now visual improvement. We expect patients are going to get better ... . But we still need more information about long-term follow-up and safety," Dr. Williams said.
Lucentis (ranibizumab, Genentech) is now the "standard of care," but the current dosing regimens and delivery techniques are less than ideal, he said.
"We also need to improve efficacy for the 60% of patients that do not have that three-line improvement. So we need to identify the adverse predictive factors and investigate combination therapies," Dr. Williams said.
Surgeons must take into account their patients' overall quality of life by considering the visual acuity in the non-treated eye as well as the logistical factors and costs associated with treatment, he said.
Other unanswered questions concern the length of treatment, the role of re-treatment and the role of imaging, such as optical coherence tomography and fluorescein angiography, Dr. Williams noted.
"We're going to need evidence-based answers," he said. "In ophthalmology, we must take the lead in providing these answers to ensure we're going to have access to this technology for our patients."