Experts explore protocols for switching anti-VEGFs | Ophthalmology

“A person should continue to improve until they have no activity. If they stop improving, I’ll do one more [injection] and say, ‘Well, maybe I’m just not analyzing it’ or ‘There’s some biological variability,’ but after two injections of not improving, then you want to consider that you have the ability to switch,” Bressler said.

 

“People switch, but they also have additional treatments, and had they continued with the same treatment over time, they might have seen the same benefit. And, again, they show benefits anatomically and not in visual acuity. So, I do think it’s worthwhile if they’re worsening. If someone’s no longer improving, why not try another agent that’s been shown to work?”

 

Bressler said, in a case of long-term anti-VEGF treatment – 24 treatments – a dramatic change 1 month after a switch in therapy is unlikely to be due to the additional time of therapy.

 

said. This is where you want to get a fluorescein angiogram, possibly an ICG, but the other thing I would do here is go ahead and give an anti-VEGF, then see the patient in a week or two to see if it’s actually a VEGF-driven disease. Once you’ve established that, then I think it’s reasonable to consider switching.” –

 

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