Response to ‘Patterns of ranibizumab and aflibercept treatment of central retinal vein occlusion in routine clinical practice in the USA’

Sir,

We are grateful that Dan and Mihai Călugăru¹ took interest in our article and opened the debate on the optimal level of anti-VEGF in the treatment of central retinal vein occlusion. Our analysis aimed at understanding the real-world treatment patterns of aflibercept and ranibizumab in the United States. We agree with Dan and Mihai Călugăru that the observed treatment patterns in our analysis should not be interpreted as the optimal treatment frequency. In fact, in our conclusions, we recommend conducting further studies to link our findings to visual outcomes that were not available in the claims database at our disposal. The analysis of electronic medical records, similar to the study conducted by the UK Age-Related Macular Degeneration EMR Users Group, and the analysis of the LUMINOUS observational data will be an important contribution to the debate.^{2, 3}