{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T03:18:52Z","timestamp":1781839132397,"version":"3.54.5"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Graefes Arch Clin Exp Ophthalmol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"Abstract<\/jats:title>\n \n Purpose<\/jats:title>\n Dutch guidelines recommend bevacizumab as first-line treatment for neovascular age-related macular degeneration (nAMD) due to its lower cost and comparable outcomes to other anti-VEGF agents. However, Dutch clinics report higher injection frequencies than international counterparts, raising concerns about treatment burden. This pilot study compares 24-month real-world outcomes of initiating aflibercept versus bevacizumab in Dutch community ophthalmology clinics.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted an observational study using prospective data from three Dutch FRB registry clinics. Two clinics used bevacizumab with two-weekly T&E interval adjustments. A third clinic initiated aflibercept with a four-week initial extension, followed by two-weekly adjustments. Primary outcomes were total injections and injections to CNV inactivity. Secondary outcomes included time to CNV inactivity, VA change, and final injection interval.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We included 43 eyes (38 patients) in the aflibercept group and 129 eyes (119 patients) in the bevacizumab group, matched 1:3 on age and baseline VA. At 24 months, mean VA was 65.6 (aflibercept) vs. 68.8 (bevacizumab) letters (\n p<\/jats:italic>\n \u2009=\u20090.182), and mean letter gains were +\u20090.8 vs.\u2009+\u20094.2 (\n p<\/jats:italic>\n \u2009=\u20090.113). Aflibercept-treated eyes received 5.5 fewer injections (\n p<\/jats:italic>\n \u2009<\u20090.001), required 5.6 fewer injections to achieve CNV inactivity (\n p<\/jats:italic>\n \u2009<\u20090.001), and reached inactivity 20.6 weeks earlier (\n p<\/jats:italic>\n \u2009=\u20090.001). Final injection intervals were 3.3 weeks longer with aflibercept (\n p<\/jats:italic>\n \u2009<\u20090.001); 41.9% reached intervals\u2009\u2265\u200912 weeks compared to 14.7% in the bevacizumab group (\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Aflibercept under a modified T&E regimen resulted in fewer injections, faster disease control and longer treatment intervals, while VA was not significantly different.<\/jats:p>\n <\/jats:sec>\n \n Key messages<\/jats:title>\n <\/jats:sec>\n \n \n \n What is known<\/jats:italic>\n <\/jats:bold>\n <\/jats:title>\n \n \n \n Aflibercept and bevacizumab are both widely used anti-VEGF injections for age-related macular degeneration with similar visual outcomes.<\/jats:p>\n <\/jats:list-item>\n \n Real-world studies in the Netherlands report a high injection burden with bevacizumab, but direct comparisons between agents in routine care are limited.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n \n \n What is new<\/jats:italic>\n <\/jats:bold>\n <\/jats:title>\n \n \n \n Aflibercept, initiated with a modified treat-and-extend regimen, achieved visual outcomes comparable to bevacizumab while requiring fewer injections.<\/jats:p>\n <\/jats:list-item>\n \n These findings highlight aflibercept\u2019s potential to reduce treatment burden and optimize healthcare resources, warranting confirmation in larger, long-term real-world studies, as well as cost-effectiveness studies.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1007\/s00417-025-07082-3","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T09:18:35Z","timestamp":1768036715000},"page":"1355-1362","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real-world treatment outcomes of aflibercept versus bevacizumab for neovascular age-related macular degeneration"],"prefix":"10.1007","volume":"264","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6926-0492","authenticated-orcid":false,"given":"Haras","family":"Mhmud","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen P.","family":"Vermeulen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beritan","family":"Adanc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen B.J.","family":"Klevering","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolien","family":"Groenink-Lindenhovius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odette A.M.","family":"Tigchelaar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodorus L.","family":"Ponsioen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline C.W.","family":"Klaver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella N.","family":"Witmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,10]]},"reference":[{"issue":"2","key":"7082_CR1","doi-asserted-by":"publisher","first-page":"e106","DOI":"10.1016\/S2214-109X(13)70145-1","volume":"2","author":"WL Wong","year":"2014","unstructured":"Wong WL, Su X, Li X et al (2014) Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. 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