Advancements in Retinal Therapeutics: Insights from the TALON Phase IIIb Study

The TALON trial demonstrates that a treat‑and‑extend regimen using a longer‑acting anti‑VEGF can materially reduce injection frequency and patient burden in neovascular AMD; crucially, interval extension was achievable without loss of visual efficacy through 64 weeks.

Phase IIIb randomised, head‑to‑head design combined treat‑and‑extend delivery with imaging‑guided, masked assessments of disease activity. The protocol explicitly targeted interval extension, visual acuity, anatomical OCT endpoints and masked investigator adjudication of activity—measures chosen to evaluate both functional outcomes and operational feasibility, the twin drivers of clinic workflow efficiency.

By Week 64, 28.4% of patients reached a 16‑week interval on brolucizumab versus 12.2% on aflibercept, a clear increase in the proportion of eyes able to sustain q16w dosing. That higher q16w yield translates into a meaningful reduction in annual injection visits for a subset of patients when pathway selection prioritises interval extension.

Mean visual‑acuity gains were comparable between arms over the Week 60–64 window, while OCT anatomy favored the agent that allowed longer spacing—showing greater fluid resolution and larger mean reductions in central subfield thickness. Similar vision outcomes alongside superior anatomical control and spacing flexibility support choosing therapy that balances durable retinal drying with individualized visual goals.

Safety findings aligned with prior experience but require attention: the brolucizumab arm had higher rates of certain ocular adverse events, including intraocular inflammation, retinal vasculitis and retinal vascular occlusion. These events remained infrequent in absolute terms, but their increased incidence means interval extension is best considered for appropriately selected patients with rigorous pre‑injection screening and ongoing OCT‑guided vigilance.