From the Guidelines
The Susvimo (ranibizumab) implant is indicated for patients with neovascular (wet) age-related macular degeneration (AMD) who have previously responded to at least two anti-VEGF injections. This is based on the understanding that early treatment of AMD is associated with a more favorable prognosis, and anti-vascular endothelial growth factor (VEGF) treatment given within 2 years after diagnosis of neovascular AMD has been shown to reduce legal blindness and visual impairment 1. The implant delivers 100 mg/mL of ranibizumab continuously into the vitreous, requiring refills approximately every 6 months rather than monthly injections.
Key Considerations
- Patient selection factors such as ability to return for monitoring and refill procedures
- Contraindications including ocular or periocular infections, active intraocular inflammation, or hypersensitivity to ranibizumab
- Potential complications include endophthalmitis, retinal detachment, implant dislocation, vitreous hemorrhage, and conjunctival erosion or retraction
Benefits and Implications
The Susvimo system offers comparable efficacy to monthly ranibizumab injections while significantly reducing treatment burden, making it particularly valuable for patients with difficulty adhering to frequent injection schedules or those experiencing significant anxiety with repeated injections. As noted in the comprehensive adult medical eye evaluation preferred practice pattern, early treatment of AMD is crucial, and the use of anti-VEGF medications like ranibizumab has been shown to improve outcomes in patients with neovascular AMD 1.
Procedure and Monitoring
The surgical procedure involves creating a scleral incision and placing the implant in the pars plana. Patients require close monitoring for complications, particularly in the early post-operative period. Given the risks associated with AMD progression, including significant decline in quality of life and increased need for assistance with activities of daily living, the use of the Susvimo implant can be a valuable treatment option for eligible patients 1.
From the Research
Indications for Susvimo Implant
- The Susvimo implant is indicated for patients with neovascular age-related macular degeneration (nAMD) who require continuous treatment with anti-vascular endothelial growth factor (VEGF) therapy 2.
- The implant is a port-delivery system that delivers a novel formulation of ranibizumab, which can be refilled at six months or longer, reducing the treatment burden associated with frequent intravitreal injections 2.
Considerations for Using Susvimo Implant
- The effectiveness of the Susvimo implant in improving visual acuity and reducing retinal thickness has been demonstrated in clinical trials, with results showing that ranibizumab can improve visual acuity by 6 to 12 letters from baseline 3.
- The treatment regimen for nAMD should be tailored to the individual patient, with a treat-and-extend regimen being optimal to avoid overtreatment or insufficient treatment 3.
- The Susvimo implant has been shown to be a viable alternative to traditional anti-VEGF injections, with the potential to reduce the frequency of injections and improve treatment adherence 2, 4.
- The safety and efficacy of the Susvimo implant should be carefully evaluated in each patient, taking into account the potential risks and benefits of treatment, including the risk of macular atrophy and choroidal thinning 3, 5.
- Other anti-VEGF agents, such as aflibercept and brolucizumab, may also be considered for the treatment of nAMD, and the choice of therapy should be based on individual patient needs and circumstances 3, 6.