Long-term Visual Outcomes Following Anti-VEGF Therapy for Neovascular Age-related Macular Degeneration

neovascular age-related macular degeneration; anti-VEGF; ranibizumab; aflibercept; bevacizumab; faricimab; longterm visual outcomes; visual acuity; realworld evidence; retinal disease.

1Basmah Mohammed Ghanem Alhazmi
Khamis myshet general hospital,
Ophthalmology specialist

2Dr. Mohammed Saed Almalki
Retina Consultant, King Abdullah Medical
City, Makkah

3Razan Shaker M Asiri
Aseer central hospital, Ophthalmology
specialist

4Omar Mohammad Almatrafi
Department of Ophthalmology, Faculty of
Medicine, Imam Abdulrahman Bin Faisal
University, Al Khobar, Saudi Arabia

5Dr. Bander Alqahtani
Ophthalmology Consultant, Jeddah Eye
Hospital

6Fahad Mohammed al wadai
Aseer central hospital, Ophthalmology
Resident

7Mohammed Mubrik Obaid Almatrafi
Assir Central Hospital, Ophthalmology
Resident

8Yara Abdullah M alziyad
Aseer central hospital, Abha, Medical intern

9Yara Ahmed S Alshehri
Medical intern, KKU

10Lama Mohammed A Alshehri
Medical intern , KKU

Received: 02-06-2026
Revised: 24-07-2026
Accepted: 08-08-2026

European Journal of Prosthodontics and Restorative Dentistry (2026) 34 (7s), 1419–1430

Long-term Visual Outcomes Following Anti-VEGF Therapy for Neovascular Age-related Macular Degeneration

Neovascular age-related macular degeneration (nAMD) remains the leading cause of irreversible central vision loss among older adults in developed countries. The introduction of intravitreal vascular endothelial growth factor (VEGF) inhibitors has revolutionized disease management, transforming nAMD from a rapidly blinding condition into a chronic, treatable disorder. Landmark randomized clinical trials demonstrated substantial improvements in visual acuity during the first two years of treatment; however, maintaining these gains over longer follow-up periods remains a significant clinical challenge. Long-term visual outcomes are influenced by multiple factors, including treatment regimen, injection frequency, baseline visual acuity, lesion characteristics, patient adherence, and the progressive development of macular atrophy and subretinal fibrosis. Furthermore, discrepancies between randomized clinical trials and real-world practice highlight the impact of undertreatment and healthcare resource limitations on long-term visual preservation. Recent therapeutic advances, including faricimab, high-dose aflibercept, sustained drug-delivery systems, gene therapy, and artificial intelligence-assisted treatment strategies, offer promising opportunities to reduce treatment burden while maintaining visual outcomes. This review critically evaluates evidence from landmark clinical trials, extension studies, and real-world registries regarding long-term visual outcomes following anti-VEGF therapy for nAMD. Particular emphasis is placed on determinants of long-term visual prognosis, current therapeutic challenges, emerging treatment strategies, and practical recommendations for optimizing lifelong management.

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