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Neovascular age-related macular degeneration (nAMD) is a leading cause of blindness in the elderly, and anti-vascular endothelial growth factor (VEGF) therapy is currently the primary treatment approach. However, the real-world effectiveness of nAMD treatment is not always satisfactory and faces various challenges. Frequent administration and follow-up burdens can lead to decreased patient compliance during long-term treatment, resulting in suboptimal outcomes. Some lesions exhibit poor or no response to anti-VEGF treatment, leading to difficulties in maintaining or even declining visual acuity. Factors such as lesion fibrosis and tissue atrophy can contribute to visual deterioration. Therefore, standardizing and individualizing treatment plans, along with enhancing comprehensive monitoring and management throughout the disease course, are crucial improvement measures. The evidence-based guidelines for diagnosis and treatment of age-related macular degeneration in China, released in 2023, provide guidance for standardized clinical diagnosis and treatment. Meanwhile, research and development of new drugs and administration methods are anticipated for the future.

Age-related macular degeneration(AMD) is one of the main leading causes of irreversible vision damage in patients over 50 years old. Genetic factors play an important role in the occurrence and development of AMD. Since the significant correlation between complement factor H (CFH) gene and AMD was found, the pharmacogenomics of CFH polymorphism was paid close attention by academic circles. Among which, studies concerning CFH Y402H were more deeply. Studies have found CFH Y402H genotypes might lead to differences toward the outcome of PDT and anti-VEGF treatment. In this article, we review the researches on the pharmacogenomics of CFH Y402H in wet AMD treatment. (Chin J Ophthalmol, 2017, 53: 144-147) .

Objectives: To determine the characteristics and clinical significance of outer retinal tabulation (ORT) in wet age-related macular degeneration (wAMD) treated by anti-vascular endothelial growth factor (anti-VEGF) through optical coherence tomography (OCT)., Methods: The 35 wAMD patients with 39 ORT eyes treated by anti-VEGF were examined by OCT to determine the morphological features and evolution of the ORTs over time and their response to anti-VEGF., Results: ORTs were located in the places that exudation or edema had happened in the outer nuclear layer of retina.38 ORTs remained stable on both quantity and morphology.One ORT became invisible temporarily and then reappeared., Conclusions: ORTs are reconstructed by photoreceptor cells that have survived after outer retina damages.There is no connection between anti-VEGF treatment and ORT formation.

Anti-VEGF therapy is currently one of the main treatments for neovascular age-related macular degeneration (nAMD). Clinically, patients under standardized anti-VEGF therapy showed different responses, of which recurrences or even insensitivity were found in some patients. However, the specific definitions of these various clinical responses are still unclarified. Therefore, to consolidate and define these concepts are of great importance regarding to future efficacy comparison, treatment response clarification and novel drug switching therapies.

Objective: To observe the efficacy and safety of intravitreal injection of conbercept, a new drugs of VEGFR fusion proteins, on wet age-related macular degeneration (wAMD)., Methods: To analyze retrospectively the clinical data of 58 patients with wet wAMD, which was diagnosed by examination of ETDRS charts, color fundus photograph, fluorescein angiography (FFA) and optical coherence tomography (OCT), were underwent intravitreal injection conbercept 0.5 mg (0.05 ml of 10 g/L). Follow-up time was 6 to 12 months.Visual acuity (ETDRS charts letter), retinal thickness, leakage of CNV and operative complications before and after the treatment were analyzed., Results: Conbercept injection therapeutic times were 3-5, the average therapeutic times were 3.05. At the end of the follow-up period, the mean letter of ETDRS charts was 50.20±12.87, increased 26.20 letters (t=2.936, P<0.01). the ETDRS charts improved 15 or more letters in 33 eyes (53.23%), decreased more than 15 letters in 2 eyes (3.23%); the average foveal thickness on OCT images were (223±74) µm after treatment, decreased significantly (t=3.669, P<0.01) ; FFA showed CNV complete closure in 34 eyes (54.84%), partial closure in 23 eyes (37.10%), no change in 5 eyes (8.06%). IOP increased in 2 eyes after treatment and recovered within one week., Conclusions: Intravitreal injection of conbercept for wAMD was well tolerated, with an improvement in BCVA, macular edema and leakage of CNV, reduce the risk of rehaemorrhagia.

Intravitreal administration of anti-vascular endothelial growth factor (anti-VEGF) drugs has become the standard treatment for exudative age-related macular degeneration (AMD). However, there are some patients who do not have a sufficient response to the treatment, and some patients fail to respond to those drugs. The mechanisms of non-response to the treatment in these cases are poorly understood. These may be associated with wAMD types, vitreomacular abnormity, genetic factors, and tachyphylaxis, etc. Ophthalmologists should pay attention to those non-responders and give them the correct treatment, avoid the anti-VEGF drugs abuse and explore the best personalized treatment for those patients.