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Article | AAO 2026

Optometrists’ Role in Retinal Care in the Anti-VEGF Era

Referral shouldn't mean goodbye: Roya Attar, OD, MBA, DHA's clinical pearls for comanaging nAMD, DME, RVO, and more with retina specialists.

By: Sarah Fackler, managing editor, Optometric Management and Eyecare Business
Optometric Management October 1, 2026

Clinical Scorecard: Optometrists’ Role in Retinal Care in the Anti-VEGF Era

At a Glance

CategoryDetail
ConditionNeovascular Age-Related Macular Degeneration (nAMD), Diabetic Macular Edema (DME), Retinal Vein Occlusion (RVO)
Key MechanismsAnti-VEGF therapy for stabilization and improvement of vision
Target PopulationPatients with nAMD, DME, and RVO
Care SettingOptometric and retinal care settings

Key Highlights

  • 90% of nAMD patients maintain vision with anti-VEGF treatment.
  • 40% to 60% of DME patients experience vision improvement.
  • RVO patients show 50% to 70% improvement in vision.
  • OCT and BCVA are critical for monitoring treatment response.
  • Stability in DME is defined by CST within 10% of baseline and no new IRF.

Guideline-Based Recommendations

Diagnosis

  • Use OCT to assess central subfield thickness (CST) and presence of intraretinal fluid (IRF).
  • Monitor best-corrected visual acuity (BCVA) consistently.

Management

  • Implement treat-and-extend protocols to optimize treatment intervals.
  • Communicate with retina specialists regarding significant findings.

Monitoring & Follow-up

  • Track OCT findings and BCVA at every visit.
  • Assess anatomic and functional responses independently.

Risks

  • Monitor for neovascular complications in RVO, including rubeosis iridis.
  • Persistent IRF correlates with poorer visual outcomes.

Patient & Prescribing Data

Patients undergoing anti-VEGF therapy for retinal conditions.

Adherence to treatment schedules is crucial for maintaining vision.

Clinical Best Practices

  • Document OCT findings and BCVA consistently.
  • Compare OCT scans over time to detect subtle changes.
  • Communicate patient-reported changes and clinical findings to retina specialists.

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