{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:06:36Z","timestamp":1790697996905,"version":"4.1.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of VitreoRetinal Diseases"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Antivascular endothelial growth factor (anti-VEGF) treatment protocols for neovascular age-related macular degeneration (nAMD) have evolved from fixed, monthly, or bimonthly dosing to individualized, extended dosing regimens. Although an as-needed injection protocol may reduce the number of injections, it confers a similar treatment burden by requiring regimented follow-up visits, and disease activity may resurface between visits. Various personalized treatment intervals have been implemented in more recent randomized controlled clinical trials (RCTs), reflecting a shifting focus toward individualized, variable, extended treatment intervals rather than the frequent, fixed regimens used in older RCTs. Newer agents, such as faricimab and aflibercept 8.0 mg, have been evaluated in phase 3 RCTs and potentially offer extended durability of dosing in intervals of up to 12 to 16 weeks or longer. Recently introduced anti-VEGF agents were tested in pivotal trials using individualized, variable, extended treatment intervals, with results showing adequate nAMD control compared to older, fixed dosing regimens, but additional studies are needed to determine the real-world durability of these agents compared to older anti-VEGF agents.<\/jats:p>","DOI":"10.1177\/24741264261427831","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T13:18:31Z","timestamp":1773235111000},"page":"582-592","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Evolution of Antivascular Endothelial Growth Factor Clinical Trial Design for Treating Neovascular Age-Related Macular Degeneration"],"prefix":"10.1177","volume":"10","author":[{"given":"Michael A.","family":"Klufas","sequence":"first","affiliation":[{"name":"Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl D.","family":"Regillo","sequence":"additional","affiliation":[{"name":"Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil K.","family":"Mandava","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College, Philadelphia, PA, USA"},{"name":"University of Colorado Anschutz Medical Campus, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1712-0513","authenticated-orcid":false,"given":"Evelyn G.","family":"Miller","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2022.4401"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa054481"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062655"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2008.10.018"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2007.10.004"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1102673"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.04.015"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.09.006"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2013.08.011"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.10.014"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2019.04.017"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xops.2021.100076"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2021.09.016"},{"key":"e_1_3_2_15_2","unstructured":"Regeneron Pharmaceuticals Inc. Two-year PULSAR trial results for aflibercept 8 mg demonstrate durable vision gains at extended dosing intervals in wet age-related macular degeneration. 2023. Accessed May 13 2024. https:\/\/investor.regeneron.com\/news-releases\/news-release-details\/two-year-pulsar-trial-results-aflibercept-8-mg-demonstrate\/"},{"key":"e_1_3_2_16_2","unstructured":"Clark L. 96-week efficacy and safety of aflibercept 8 mg in nAMD: an update from the PULSAR study. Presented at: Angiogenesis Exudation and Degeneration - Virtual Edition; February 3 2024; Bascom Palmer Eye Institute."},{"key":"e_1_3_2_17_2","unstructured":"Wong TY. Three-year outcomes of aflibercept 8 mg in nAMD: safety and efficacy results from the PULSAR extension study. Presented at: Angiogenesis Exudation and Degeneration - Virtual Edition; February 8 2025; Bascom Palmer Eye Institute."},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2013.107"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-023-02261-x"}],"container-title":["Journal of VitreoRetinal Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24741264261427831","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/24741264261427831","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/24741264261427831","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:26:39Z","timestamp":1790695599000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/24741264261427831"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,10]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/24741264261427831"],"URL":"https:\/\/doi.org\/10.1177\/24741264261427831","relation":{},"ISSN":["2474-1264","2474-1272"],"issn-type":[{"value":"2474-1264","type":"print"},{"value":"2474-1272","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,10]]}}}