Skill Checkup: A 61-Year-Old Man With Central Visual Acuity Blurring

F. Ryan Prall, MD


September 24, 2021

Intravitreal injection therapy using anti-vascular endothelial growth factor (VEGF) agents is considered first-line treatment for AMD. Early diagnosis and treatment initiation, particularly with VEGF agents, has been shown to improve visual and anatomic outcomes.

Other management options for exudative AMD include photodynamic therapy, and laser photocoagulation surgery can be used to treat neovascular AMD. Although the DENALI and MONT BLANC trials did not show a significant benefit of adding photodynamic therapy to anti-VEGF therapy in new-onset neovascular AMD, several others have shown that combination therapy did require fewer anti-VEGF injections. In addition, although the use of antioxidant vitamin and mineral supplements has been shown to reduce progression of intermediate to acute stage AMD, it has not yet been shown to reduce the progression of early AMD to intermediate AMD. Thermal laser photocoagulation surgery is no longer included in the recommended therapies for subfoveal CNV.

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