OUR SITES: Centre for Sustainable Healthcare | Sustainable Action Planning | NHS Forest | Mapping Greener Healthcare | Carbon Addict

“Treat and Extend regimen” for Anti Vascular Endothelial Growth Factor (VEGF)

By: City Hospitals Sunderland NHS Foundation Trust

Project Description

Background: For neovascular age-related macular degeneration (nAMD), the ideal treatment regimen has not been determined. To address patient outcomes and resource use, a “Treat and Extend regimen” was applied for anti-vascular endothelial growth factor (VEGF) in nAMD.

Approach: With a “Treat and Extend regimen,” the aim is to individualise and gradually increase treatment intervals without reducing visual outcomes (i.e. quarterly injections instead of monthly injections). The team tested two separate drug treatments with the regimen: Eylea and Lucentis.

Intended Benefits

Patient outcomes: Under the new regimen, patients have visual outcomes similar to the previous approach.

Environmental, Financial, Social: A modified “Treat and Extend” approach reduces treatment burden and decreases monitoring visits, which would decrease the time spent travelling and associated carbon emissions.

Potential Barriers

Challenges to implementing this system could be:

  • More resource intensive at start (number of injections may be higher during the year 1 and 2)
  • Training staff to implement new regimen
  • Patient adjustment and agreement to new regimen

Key Aspects of the Project

This project focused on a change in treatment that could reduce resource usage and improve patient experience.


Sunderland Eye Infirmary

Rehab Ismail, n/a