Updated guidelines for the management of neovascular age-related macular degeneration by the European Society of Retina Specialists (EURETINA).

Since the publication in 2014 of the original EURETINA guidelines for the management of neovascular age-related macular degeneration (nAMD), the treatment landscape for this prevalent and potentially devastating condition has evolved substantially. Along with the introduction of new anti-vascular endothelial growth factor (anti-VEGF) agents and the release of biosimilar agents, anti-VEGF dosing strategies have been refined, and increasing amounts of clinical trial and real-world evidence are available to inform practice. To provide an updated European perspective on nAMD management, the EURETINA panel systematically reviewed European guidelines published since 2014 alongside recent randomized controlled trials and other relevant evidence. Areas of broad consensus across guidelines were identified, including the importance of early diagnosis and prompt initiation of anti-VEGF therapy, and the central role of optical coherence tomography (OCT) in both diagnosis and monitoring. Treat-and-extend regimens are now established as the preferred approach for retreatment, with disease activity defined primarily by changes in retinal fluid accumulation detected by OCT imaging. Recommendations also address follow-up, switching or discontinuing therapy, and referral to low vision support services. Incorporating the EURETINA panel's expertise into this synthesis, this update to the EURETINA guidelines for nAMD provides recommendations to guide high-quality, evidence-based care for patients with nAMD across Europe.