1 Guidance

This guidance has been re-issued after a change to the patient access scheme in May 2012. See About this guidance for more information.


Ranibizumab, within its marketing authorisation, is recommended as an option for the treatment of wet age-related macular degeneration if:

  • all of the following circumstances apply in the eye to be treated:

    • the best-corrected visual acuity is between 6/12 and 6/96

    • there is no permanent structural damage to the central fovea

    • the lesion size is less than or equal to 12 disc areas in greatest linear dimension

    • there is evidence of recent presumed disease progression (blood vessel growth, as indicated by fluorescein angiography, or recent visual acuity changes)

  • the manufacturers of ranibizumab (branded or biosimilar) only provide it at a discount level no lower than the discount agreed in the patient access scheme.


It is recommended that treatment with ranibizumab should be continued only in people who maintain adequate response to therapy. Criteria for discontinuation should include persistent deterioration in visual acuity and identification of anatomical changes in the retina that indicate inadequate response to therapy. It is recommended that a national protocol specifying criteria for discontinuation is developed.


Pegaptanib is not recommended for the treatment of wet age-related macular degeneration.


People who are currently receiving pegaptanib for any lesion type should have the option to continue therapy until they and their clinicians consider it appropriate to stop.