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Invited Commentary
May 2016

Managing Neovascular Age-Related Macular Degeneration: Is More Research Needed to Improve Real-world Practice?

Author Affiliations
  • 1Department of Translational Surgery and Medicine, Eye Clinic, University of Florence, Florence, Italy
  • 2Department of Ophthalmology, Fondazione G. B. Bietti per lo Studio e La Ricerca in Oftalmolologia, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
  • 3Cochrane Germany, University Medical Center Freiburg, Freiburg
JAMA Ophthalmol. 2016;134(5):553-554. doi:10.1001/jamaophthalmol.2016.0332

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.

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