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Article | 2026 AAO Meeting

Two-Year PRISM Data Show Reduced Treatment Burden

Veeral Sheth, MD, discusses the durability, safety, and supplemental injection requirements of intravitreal 4D-150 gene therapy for wet AMD.

By: Veeral S. Sheth, MD, MBA, FACS, Diana V. Do, MD
Retinal Physician October 10, 2026

Clinical Scorecard: Two-Year PRISM Data Show Reduced Treatment Burden

At a Glance

CategoryDetail
ConditionNeovascular age-related macular degeneration (wet AMD)
Key MechanismsIntravitreal 4D-150 gene therapy; the article describes treatment durability and reduced need for supplemental injections.
Target PopulationPatients with neovascular AMD, including recalcitrant patients and more recently diagnosed patients enrolled in the phase 1/2 PRISM program.
Care SettingRetina care and clinical-trial settings; the article reports two-year phase 1/2 data and planned phase 3 topical steroid use.

Key Highlights

  • Two-year phase 1/2 PRISM data showed stability in central subfield thickness and best-corrected visual acuity.
  • Among recalcitrant patients, 22% received no injections over two years, and close to 59% needed two or fewer supplemental treatments.
  • Among more recently diagnosed patients, 66% needed no supplemental treatments at two years, and close to 90% needed two or fewer injections.
  • The speaker said patients in the trial and phase 3 study would receive topical steroids for 20 weeks, with drops tapered over that period.

Guideline-Based Recommendations

Diagnosis

    Management

    • The speaker described 4D-150 as an intravitreal gene therapy being studied for neovascular AMD.
    • The speaker said the trial and phase 3 study would use topical steroids for 20 weeks, tapered over that period, to blunt inflammation.

    Monitoring & Follow-up

    • The reported two-year outcomes included central subfield thickness, best-corrected visual acuity, and supplemental injection requirements.

    Risks

    • The speaker noted that patients with higher disease activity may still require supplemental treatment.
    • The speaker described inflammation as a concern addressed with topical steroids; the article does not provide specific safety-event rates.

    Patient & Prescribing Data

    PRISM phase 1/2 participants with neovascular AMD, including recalcitrant patients previously receiving almost monthly treatment and more recently diagnosed patients.

    Over two years, 22% of recalcitrant patients received no injections and close to 59% received two or fewer supplemental treatments. Among more recently diagnosed patients, 66% received no supplemental treatments and close to 90% received two or fewer injections.

    Clinical Best Practices

    • Do not assume treatment will be one-and-done; the speaker noted that patients with higher disease activity may need additional treatment.
    • The speaker described a 20-week course of topical steroids, tapered over that period, in the trial and phase 3 study.

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