Treat-and-Extend in Retinal Vascular Diseases

Welcome back to another AJMC Insights series. In this episode titled, “Treat-and-Extend in Retinal Vascular Diseases,” the panel explores how treat-and-extend strategies have become a foundational approach to managing retinal vascular diseases such as neovascular age-related macular degeneration (AMD), diabetic macular edema (DME), and retinal vein occlusion (RVO). The expert faculty discuss how retina specialists individualize treatment intervals based on disease activity, balancing disease control with the goal of reducing injection burden and improving long-term adherence.

The panel explains that treat-and-extend approaches are designed to identify each patient’s minimum effective treatment frequency by gradually extending intervals when retinal disease remains stable and shortening intervals if recurrence occurs. The discussion highlights how this approach has evolved alongside next-generation anti-VEGF therapies, including faricimab and aflibercept 8 mg, which may allow some patients to achieve longer dosing intervals while maintaining disease control.

In addition, the expert faculty examine the broader economic and access implications associated with treatment interval management in real-world clinical practice. The panel emphasizes that payer assumptions based solely on labeled dosing schedules or pivotal clinical trials may not fully reflect how therapies are used in everyday retina care. The discussion also explores how real-world treatment patterns influence healthcare resource utilization, patient burden, and pharmacoeconomic evaluations for anti-VEGF therapies. Throughout the episode, the panel reinforces the importance of aligning access policies and treatment expectations with real-world clinical practice to optimize long-term patient outcomes in retinal vascular diseases.

In the next episode, “Economic Burden in Retinal Vascular Diseases,” panelists will continue their discussion on retinal vascular diseases and highlight how treatment burden, affordability challenges, and healthcare resource utilization influence real-world anti-VEGF therapy management. The expert faculty will also examine how financial barriers and patient access issues may affect adherence, treatment persistence, and long-term visual outcomes.