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TREAT-AND-EXTEND REGIMENS WITH ANTI-VEGF AGENTS IN RETINAL DISEASES: A Literature Review and Consensus Recommendations.
Freund, KB, Korobelnik, JF, Devenyi, R, Framme, C, Galic, J, Herbert, E, Hoerauf, H, Lanzetta, P, Michels, S, Mitchell, P, et al
Retina (Philadelphia, Pa.). 2015;(8):1489-506
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Abstract
PURPOSE A review of treat-and-extend regimens (TERs) with intravitreal anti-vascular endothelial growth factor agents in retinal diseases. METHODS There is a lack of consensus on the definition and optimal application of TER in clinical practice. This article describes the supporting evidence and subsequent development of a generic algorithm for TER dosing with anti-vascular endothelial growth factor agents, considering factors such as criteria for extension. RESULTS A TER algorithm was developed; TER is defined as an individualized proactive dosing regimen usually initiated by monthly injections until a maximal clinical response is observed (frequently determined by optical coherence tomography), followed by increasing intervals between injections (and evaluations) depending on disease activity. The TER regimen has emerged as an effective approach to tailoring the dosing regimen and for reducing treatment burden (visits and injections) compared with fixed monthly dosing or monthly visits with optical coherence tomography-guided regimens (as-needed or pro re nata). It is also considered a suitable approach in many retinal diseases managed with intravitreal anti-vascular endothelial growth factor therapy, given that all eyes differ in the need for repeat injections. CONCLUSION It is hoped that this practical review and TER algorithm will be of benefit to health care professionals interested in the management of retinal diseases.
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[Position of the Retinological Society, the German Ophthalmological Society and the Professional Association of Ophthalmologists in Germany on the current therapeutic possibilities for neovascular age-related macular degeneration].
Klinische Monatsblatter fur Augenheilkunde. 2007;(7):559-66
Abstract
The basic conditions in the management of exudative age-related macular degeneration have changed considerably since the last statement of the German professional associations in 2006. While Pegaptanib was approved in Germany already in 2006 Ranibizumab was approved for the treatment of exudative macular degeneration in Germany in February 2007. More over the quality assurance regulations for the photodynamic treatment of choroidal neovascularizations with Verteporfin were modified including the treatment of occult lesions and implementing a simplified classification of extra- and subfoveal lesions. Consequently modification of the recommendations for the non-surgical treatment of exudative age-related macular degeneration appeared inevitable.