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The following is a summary of “Incidence and reasons for discontinuation of anti-VEGF treatment in neovascular age-related macular degeneration,” published in the March 2025 issue of British Journal of Ophthalmology by Borrelli et al. 

Researchers conducted a retrospective study to examine the factors and frequency of interruptions in intravitreal treatment for individuals with neovascular age-related macular degeneration (AMD) and analyzed the demographic and clinical factors associated with treatment discontinuation.  

They analyzed individuals with treatment-naïve neovascular exudative AMD who initiated anti-vascular endothelial growth factor (VEGF) therapy between January 2019 and December 2021. The overall (OA) incidence of treatment discontinuation and rates for each specific cause were calculated. The probability of each discontinuation caused over time from treatment initiation and the associated risk factors were also determined.  

The results showed that 655 individuals (28.5%) discontinued intravitreal anti-VEGF therapy. Among the 5 main reasons for discontinuation (patient’s decision against clinician’s advice, continuation of therapy at another clinic, clinical decision, systemic diseases, or death), clinical decision was the most common cause. Kaplan–Meier curve analysis indicated a higher frequency of clinical decision-related discontinuation within the first two years of treatment. Worse visual acuity increased the likelihood of discontinuation due to clinical decisions, while younger individuals were more likely to stop treatment by choice. Better visual acuity and greater distance from the clinic were associated with a higher probability of continuing therapy elsewhere.  

Investigators concluded that anti-VEGF treatment discontinuation in neovascular AMD was frequent, stopping both clinician-directed and patient-influenced factors, encompassing health status and personal preferences. 

Source: bjo.bmj.com/content/early/2025/03/22/bjo-2024-326152