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1. The prevalence of neovascular age-related macular degeneration (nAMD) continues to increase in part because of an aging population (in the US and worldwide) and increased life span. The introduction of anti-vascular endothelial growth factor (anti-VEGF) therapies has affected complications due to nAMD in which of the following ways?

A. No change in the prevalence of blindness or other disability B. Increase in the prevalence of blindness due to limited availability and efficacy of anti-VEGF therapies C. Decrease in the incidence of nAMD due to the use and efficacy of anti-VEGF therapies D. Decrease in the prevalence of blindness due to the use and efficacy of anti-VEGF therapies E. Unsure

2. As the rate of diabetes increases, complications such as diabetic macular edema (DME) are also increasing. Which of the following strategies would NOT be helpful in mitigating the risk of DME in persons with diabetes?

A. Early introduction of anti-VEGF therapies in asymptomatic DME B. Healthy diet and exercise habits C. Long-term management of blood glucose, blood pressure, and cholesterol D. Annual eye exams E. Unsure

3. Which of the following is a major benefit of Treat-and-Extend (T&E) treatment approaches?

A. Follow dose and dosing frequency per prescribing information B. Decrease treatment burden while maintaining efficacy C. Increase dose and dosing frequency as needed D. Increase dosing frequency and decrease dose as needed E. Unsure

4. Since the high frequency of injections for anti-VEGF therapies can lead to decreased adherence to therapy, research has continued on ways to extend anti-VEGF durability. Which of the following is NOT an approach under investigation to extend anti-VEGF durability?

A. Refillable intravitreal drug delivery implants B. Biodegradable polymeric nanoparticles for extended drug release C. Drugs with non-VEGF mechanisms of action D. One-time treatments through gene therapy E. Unsure

5. nAMD/DME are conditions affected by multiple factors. While the VEGF pathway is a target for current and emerging therapies, which of the following is another pathway under investigation as a target to treat nAMD/DME?

A. Peroxisome proliferator-activated receptor (PPAR)-alpha pathway B. PPAR-gamma pathway C. Angiopoietin-tyrosine kinase endothelial (Ang-Tie) receptor pathway D. Angiotensin-converting enzyme (ACE) pathway E. Unsure

6. FM is a 72-year-old white man who just received a diagnosis of nAMD, which affects his right eye. FM has a history of hypercholesterolemia currently managed with atorvastatin 40 mg daily. Which of the following therapies would be an appropriate treatment regimen via intravitreal injection?

A. Aflibercept 2 mg every 4 weeks x 3 months followed by 2 mg every 8 weeks B. Brolucizumab 2 mg monthly x 3 doses followed by 2 mg every 8-12 weeks C. Fluocinolone acetonide 0.19 mg every 3 months D. Dexamethasone 0.3 mg every 6 weeks E. Unsure

7. Which of the following is an anti-VGEF biosimilar currently approved by the FDA for use in the eye?

A. Bevacizumab-vikg B. Ranibizumab-nuna C. Ranibizumab-biog D. Brolucizumab-dbll E. Unsure

8. A policy change in January 2019 by the Centers for Medicare & Medicaid Services (CMS) allowed for the implementation of step therapy for Part B drugs. Which of the following best describes the potential impact on patients with nAMD or DME who are candidates for anti-VEGF drugs?

A. No impact as anti-VEGF drugs are not typically covered under Part B B. Limited impact as step therapy is almost universally welcomed by ophthalmologists C. Limited impact since step therapy would follow current nAMD/DME treatment guidelines D. Potentially negative impact since step therapy could delay optimal application of therapy E. Unsure

9. The patient-centered medical model for therapy selection has 4 components. Which of the following is a component of this model?

A. Enhancing Patient Education B. Enhancing the Patient-Centered Relationship C. Understanding the Disease Process D. Understanding Adherence Barriers E. Unsure

Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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2. As the rate of diabetes increases, complications such as diabetic macular edema (DME) are also increasing. Which of the following strategies would NOT be helpful in mitigating the risk of DME in persons with diabetes?

3. Which of the following is a major benefit of Treat-and-Extend (T&E) treatment approaches?

4. Since the high frequency of injections for anti-VEGF therapies can lead to decreased adherence to therapy, research has continued on ways to extend anti-VEGF durability. Which of the following is NOT an approach under investigation to extend anti-VEGF durability?

5. nAMD/DME are conditions affected by multiple factors. While the VEGF pathway is a target for current and emerging therapies, which of the following is another pathway under investigation as a target to treat nAMD/DME?

6. FM is a 72-year-old white man who just received a diagnosis of nAMD, which affects his right eye. FM has a history of hypercholesterolemia currently managed with atorvastatin 40 mg daily. Which of the following therapies would be an appropriate treatment regimen via intravitreal injection?

7. Which of the following is an anti-VGEF biosimilar currently approved by the FDA for use in the eye?

8. A policy change in January 2019 by the Centers for Medicare & Medicaid Services (CMS) allowed for the implementation of step therapy for Part B drugs. Which of the following best describes the potential impact on patients with nAMD or DME who are candidates for anti-VEGF drugs?

9. The patient-centered medical model for therapy selection has 4 components. Which of the following is a component of this model?

10. The anti-VGEF therapies are typically covered under which part of Medicare?

Evaluation Questions

11. How confident are you in your treatment choice for FM in question #6?

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Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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2. As the rate of diabetes increases, complications such as diabetic macular edema (DME) are also increasing. Which of the following strategies would NOT be helpful in mitigating the risk of DME in persons with diabetes?

3. Which of the following is a major benefit of Treat-and-Extend (T&E) treatment approaches?

4. Since the high frequency of injections for anti-VEGF therapies can lead to decreased adherence to therapy, research has continued on ways to extend anti-VEGF durability. Which of the following is NOT an approach under investigation to extend anti-VEGF durability?

5. nAMD/DME are conditions affected by multiple factors. While the VEGF pathway is a target for current and emerging therapies, which of the following is another pathway under investigation as a target to treat nAMD/DME?

6. FM is a 72-year-old white man who just received a diagnosis of nAMD, which affects his right eye. FM has a history of hypercholesterolemia currently managed with atorvastatin 40 mg daily. Which of the following therapies would be an appropriate treatment regimen via intravitreal injection?

7. Which of the following is an anti-VGEF biosimilar currently approved by the FDA for use in the eye?

8. A policy change in January 2019 by the Centers for Medicare & Medicaid Services (CMS) allowed for the implementation of step therapy for Part B drugs. Which of the following best describes the potential impact on patients with nAMD or DME who are candidates for anti-VEGF drugs?

9. The patient-centered medical model for therapy selection has 4 components. Which of the following is a component of this model?

10. The anti-VGEF therapies are typically covered under which part of Medicare?

Evaluation Questions

11. How confident are you in your treatment choice for FM in question #6?

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