What Is the Treat and Extend Method for Wet AMD?
Last updated: May 2023
Wet macular degeneration (AMD) happens when the macula, or central part of the retina, is damaged by the growth of new blood vessels. Those blood vessels can cause swelling or leak fluid into the back of the eye.1,2 Wet AMD needs to be treated regularly to prevent damage and loss of vision. Traditional treatment calls for monthly visits and eye injections that can be a burden for many people.1,2 However, there is an approach called “treat and extend” that may help ease that burden.3
Standard wet AMD treatment
Because wet AMD is a chronic, or long-term, condition, it may need to be treated for many years. Some people may need treatment for the rest of their lives. Treatment usually involves visiting a specialist every month for an exam and a digital picture of the back of the eye that is called retinal imaging.3,4
The visit often includes an injection of anti-vascular endothelial growth factor (VEGF) drug into the eye. Anti-VEGF drugs reduce the fluid and new blood vessel growth that damage the macula. Controlling the blood vessel swelling and growth is important for preserving vision.3,4
What is the treat and extend method?
Visiting the doctor each month for a long appointment can be difficult, especially over several years. Plus, each person responds to the disease and treatment differently. Treat and extend means that doctors can take a personalized approach to treat wet AMD.3-5
Spacing out appointments and injections
Instead of monthly visits, some doctors are widening the gap between visits so that patients do not need to have as many appointments and injections. The appointment follows the same process as a standard one, but, the doctor will move the next appointment out by an extra 2 weeks.3-5
Finding the right time span
As long as the retina stays stable the doctor will continue adding an additional 2 weeks between appointments until they find the time span that works best for that patient. The gap between visits can be up to 12 weeks. After 12 weeks the fluids are more likely to return and cause vision loss, which can be permanent if left untreated.3-5
What are the benefits of treat and extend?
Wet AMD can cause severe vision loss. This means keeping up with treatment is very important. Treat and extend allows doctors to stretch out the time between visits so that the patient maintains their eye health.3-5
Reducing the number of eye injection appointments
Monthly appointments can be inconvenient and can make it harder to maintain treatment over time.5 With treat and extend a person with wet AMD can go from having 12 appointments a year to 8 or 9. It may be easier for people with wet AMD to stick to the therapy if there are fewer appointments.3,4 Reducing the number of visits can make scheduling more flexible for the patient and the medical care professional. It can also be more affordable for patients because it reduces medical costs.5
How well does the method work?
It’s also important that the therapy works well for the patient. Studies have shown that treat and extend can give about the same results as standard therapy. One study followed over 300 people who had treat and extend for 2 years. The findings for effectiveness and safety were similar in both groups.3
Another larger trial studied 650 people with wet AMD for 12 months. The study confirmed that treat and extend was as effective as standard therapy even though there were fewer injections. Patients were able to maintain improved vision through the whole study.5
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