Treat-and-Extend Strategies in Retinal Vascular Diseases

In “Treat-and-Extend Strategies in Retinal Vascular Diseases,” our panel explores how clinicians use individualized treatment approaches to optimize disease control and durability for patients with neovascular age-related macular degeneration (AMD), diabetic macular edema (DME), and retinal vein occlusion (RVO). The discussion highlights the role of treat-and-extend strategies in helping retina specialists tailor therapy based on each patient’s disease activity and treatment needs while working to reduce injection burden over time.

The expert faculty describe how patients with retinal vascular diseases may have varying treatment requirements, ranging from high-need to lower-need disease states, and how second-generation anti-VEGF therapies are helping clinicians achieve more rapid disease control compared with earlier-generation agents. The panel discusses how therapies such as aflibercept 8 mg and faricimab may allow clinicians to extend treatment intervals more efficiently after disease stabilization, potentially reducing the frequency of injections while maintaining disease control.

In addition, the discussion examines how clinicians use incremental treatment interval extensions to determine an individual patient’s optimal dosing schedule, including intervals ranging from every 8 weeks to every 20 weeks in some patients. The panel also reviews emerging real-world experience with second-generation anti-VEGF therapies and how these agents may help reduce treatment burden and improve adherence compared with first-generation therapies. Throughout the conversation, the panel emphasizes the importance of balancing durability, individualized care, and long-term visual outcomes in the management of retinal vascular diseases.

Our next episode, “Mechanisms of Anti-VEGF Therapies in Retinal Vascular Diseases,” explores how next-generation anti-VEGF therapies differ mechanistically from earlier treatments and how these innovations may influence durability and disease control. The panelists also discuss the role of higher molar dosing, dual-pathway inhibition, and evolving pharmacologic approaches in the management of AMD, DME, and RVO.