Real-world data from a large retina database, presented at the American Society of Retina Specialists meeting, show that adherence to anti-VEGF therapy for wet age-related macular degeneration drops sharply early on. Among 158,727 patients, nearly 39% went more than 180 days without an injection within the first year, and over half had stopped by year two. By year five, only about a quarter remained on therapy.
The analysis, covering 201,768 eyes, found that non-persistent patients lost about four times as many letters of visual acuity as those who stayed on treatment (-8.0 vs -2.1). Injection frequency also declined over time, from a mean of 8.4 in year one to 6.2–6.3 in years four through eight. The researchers said the findings highlight the need for longer-lasting therapies and point to barriers like transportation and the burden of frequent visits.
A separate real-world study presented at the same meeting showed a shift in treatment choices. Bevacizumab accounted for 30% of injections in 2025, up over the three years analyzed, while aflibercept 2 mg use fell by more than half. Aflibercept 8 mg use rose 50% from 2024 to 2025. Another study found that eyes switched to bevacizumab experienced a decline in visual acuity within three months, continuing to 12 months, though retinal thickness eventually decreased with more frequent injections.