10
Management
Table 3. Treatment Recommendations and Follow-up for AMD
(cont'd)
Recommended
Treatment
Diagnoses Eligible
for Treatment
Follow-up Recommendations
Intervals Testing
Bevacizumab
intravitreal injection
1.25 mg as described in
published reports
e ophthalmologist
should provide
appropriate informed
consent with respect to
the off-label status
Macular CNV • Patients should be instructed
to promptly report symptoms
suggestive of endophthalmitis,
including eye pain or increased
discomfort, worsening eye
redness, blurred or decreased
vision, increased sensitivity to
light, or an increased number of
floaters
• Return examination
approximately 4 weeks after
treatment initially; subsequent
follow-up and treatment
depends on the clinical findings
and judgment of the treating
ophthalmologist
• Monitoring of monocular near
vision (reading/Amsler grid)
Ranibizumab
intravitreal
injection 0.5 mg as
recommended in
literature
Macular CNV
Less Commonly Used Treatments for Neovascular AMD
Photodynamic
therapy (PDT)
with verteporfin as
recommended in the
TAP and VIP reports
a
• Macular CNV, new
or recurrent, where
the classic component
is >50% of the lesion
and the entire lesion is
≤5400 μm in greatest
linear diameter
• Occult CNV may be
considered for PDT
with vision <20/50 or
if the CNV is <4 MPS
disc areas in size when
the vision is >20/50
• Juxtafoveal CNV is
an off-label indication
for PDT but may be
considered in select
cases
• Return examination
approximately every 3 months
until stable, with retreatments as
indicated
• Monitoring of monocular near
vision (reading/Amsler grid)
a
Contraindicated in patients with porphyria or known allerg y.
AMD, age-related macular degeneration; AREDS, Age-Related Eye Disease Study; CNV, choroidal
neovascularization; MPS, Macular Photocoagulation Study; OCT, optical coherence tomography;
PDT, photodynamic therapy; TAP, Treatment of Age-Related Macular Degeneration with
Photodynamic erapy; VIP, Verteporfin in Photodynamic erapy
