A 60-year-old woman presents with metamorphopsia and a central scotoma. OCT shows subretinal fluid, pigment epithelial detachment, and a type 2 choroidal neovascular membrane. The current first-line recommended anti-VEGF agent for neovascular AMD based on the VIEW 1 and VIEW 2 trial evidence is:

• A Ranibizumab 0.5 mg monthly for 24 months
• B Brolucizumab 6 mg every 12 weeks after loading
• C Bevacizumab 1.25 mg monthly off-label
• D Aflibercept 2 mg every 2 months after 3 monthly loading doses ✓

Explanation

The VIEW 1 and VIEW 2 trials (Phase III) demonstrated that aflibercept (VEGF Trap-Eye) 2 mg given every 8 weeks after three monthly loading doses was non-inferior to ranibizumab monthly for visual acuity outcomes in neovascular AMD, with fewer injections. Aflibercept binds VEGF-A, VEGF-B, and placental growth factor (PlGF) with higher affinity than ranibizumab. This dosing schedule (3 monthly + bimonthly) is now widely adopted. Brolucizumab (HAWK/HARRIER trials) allows quarterly dosing but was associated with retinal vasculitis cases requiring caution.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.