. 2023 Jul 21;12(5):2323–2346. doi: 10.1007/s40123-023-00768-z

Table 4.

Proposed disease assessment criteria to maintain, extend or reduce treatment intervals in future trials in neovascular age-related macular degeneration

Treat with monthly injections to stability then assess for signs of disease activity as below
Extend interval between injections (e.g. by 2 weeks at a time or by 4 weeks if no disease activity features present)	If no worsening in qualitative features of disease activity: • No increase in subretinal fluid or intraretinal fluid • No new subretinal hyperreflective material or retinal/subretinal haemorrhage • No change in pigment epithelial detachment height or lateral growth and no worsening in quantitative features of disease activity: • No significant increase in OCT central subfield macular thickness compared to last visit (less than 50-μm change compared to last visit and within 75 μm of best, minimal thickness recorded)
Reduce interval between injections (e.g. by 2 weeks at a time or by 4 weeks if 2 or more features of worsening disease detected)	If worsening in qualitative features of disease activity detected: • Increase in subretinal fluid or intraretinal fluid • New subretinal hyperreflective material or retinal/subretinal haemorrhage • Change in pigment epithelial detachment height or lateral growth or worsening in quantitative features of disease activity: • Significant increase in OCT central subfield macular thickness compared to last visit (less than 50-μm change compared to last visit and within 75 μm of best, minimal thickness recorded)
Consider maintaining treatment interval for a series of injections (e.g. 3) if extension of treatment interval is followed immediately by need to shorten interval again in 2 successive treatment extension phases (i.e. if extend, shorten, extend, shorten then follow this by maintaining treatment interval at shortened interval for 3 injections before thinking about extending again)

Treat with monthly injections to stability then assess for signs of disease activity as below

Extend interval between injections (e.g. by 2 weeks at a time or by 4 weeks if no disease activity features present)

If no worsening in qualitative features of disease activity:

• No increase in subretinal fluid or intraretinal fluid

• No new subretinal hyperreflective material or retinal/subretinal haemorrhage

• No change in pigment epithelial detachment height or lateral growth

and no worsening in quantitative features of disease activity:

• No significant increase in OCT central subfield macular thickness compared to last visit (less than 50-μm change compared to last visit and within 75 μm of best, minimal thickness recorded)

Reduce interval between injections (e.g. by 2 weeks at a time or by 4 weeks if 2 or more features of worsening disease detected)

If worsening in qualitative features of disease activity detected:

• Increase in subretinal fluid or intraretinal fluid

• New subretinal hyperreflective material or retinal/subretinal haemorrhage

• Change in pigment epithelial detachment height or lateral growth

or worsening in quantitative features of disease activity:

• Significant increase in OCT central subfield macular thickness compared to last visit (less than 50-μm change compared to last visit and within 75 μm of best, minimal thickness recorded)

Consider maintaining treatment interval for a series of injections (e.g. 3) if extension of treatment interval is followed immediately by need to shorten interval again in 2 successive treatment extension phases (i.e. if extend, shorten, extend, shorten then follow this by maintaining treatment interval at shortened interval for 3 injections before thinking about extending again)