Ocular Half-Life: What it Does and Does Not Mean for Intravitreal Anti-angiogenic Drug Durability

Our commentary provides a conceptual foundation for the relationship between ocular half-life and treatment durability with respect to intravitreally administered anti-angiogenic therapies typically used for the treatment of retinal diseases, such as neovascular age-related macular degeneration and diabetic macular edema. Of note, we critically examine claims suggesting that increasing the dose of aflibercept can reduce ocular clearance and, consequently, increase ocular half-life. By reviewing the available data and exploring the underlying pharmacokinetic principles, this commentary seeks to provide an evidence-based understanding of the factors influencing treatment durability in this therapeutic area.