Population-based data from registries of blind people confirm that antiangiogenic therapy has had a substantial role in reducing the burden of vision loss in patients with neovascular age-related macular degeneration (AMD).1 These data are also affirmed by results obtained from randomized clinical trials (RCTs). However, in contrast to RCTs, patient-relevant outcomes from observational studies indicate that the initial gain in visual acuity (VA) is not maintained after a few years in these patient populations. A comprehensive analysis2 of real-world ranibizumab study data confirmed that patient-relevant outcomes are considerably poorer in observational studies than those reported in RCTs using fixed or as-needed (PRN) regimens, meaning that patients with neovascular AMD are often undertreated and undermonitored in many settings.
Virgili G, Parravano M, Schmucker C. Managing Neovascular Age-Related Macular DegenerationIs More Research Needed to Improve Real-world Practice?. JAMA Ophthalmol. 2016;134(5):553-554. doi:10.1001/jamaophthalmol.2016.0332