The Efficacy of Anti-VEGFS in the Treatment of Age-Related Macular Degeneration

Abstract

Age-Related Macular Degeneration (AMD), particularly in its neovascular form, is one of the leading causes of low vision and blindness among older adults, within a context of population aging and growing demand for ocular health care. The introduction of anti-VEGF agents has altered the prognosis of these patients by enabling stabilization and, in many cases, improvement of visual acuity, although treatment requires repeated intravitreal injections and long-term follow-up. Based on this scenario, the aim of this article was to evaluate the clinical and anatomical effectiveness of the anti-VEGF drugs currently used in routine care for neovascular AMD, with emphasis on visual acuity, macular thickness, fluid control, and retreatment needs, through an integrative review of the literature from the past five years. The search was conducted in national and international databases using predefined inclusion and exclusion criteria, resulting in the selection of 12 studies encompassing different molecules, treatment regimens, and care settings. Overall, the articles report improvement or stabilization of vision and reduction of macular thickness with ranibizumab, bevacizumab, aflibercept, brolucizumab, and faricimab, provided adequate therapeutic intensity and regular monitoring are maintained. At the same time, they show that undertreatment, poor adherence, and structural limitations of health services still compromise part of the long-term outcomes. The findings reinforce anti-VEGF therapy as the cornerstone of neovascular AMD management and highlight the need to organize care models capable of ensuring continuous access and, when possible, the use of longer-acting agents to reduce injection burden.