Retina specialists treating age-related macular degeneration recommend different approaches for patients than they would choose for themselves

PURPOSE:: To evaluate the presence of cognitive biases among retina physicians when recommending treatment options for exudative age-related macular degeneration. METHODS:: Two random samples of retina specialists were surveyed regarding their treatment and dosing regimen choices among three anti-vascular endothelial growth factor biologics (aflibercept, bevacizumab, and ranibizumab). One group was asked to provide recommendations for a standardized hypothetical patient with exudative age-related macular degeneration, whereas the other group was asked to provide recommendations as if they themselves were the standardized hypothetical patient with exudative age-related macular degeneration. RESULTS:: Two hundred and twenty-six respondents (28.3%) completed the survey and were divided equally between the survey groups. For patients, most physicians recommended bevacizumab (52.2%), but when choosing for themselves, physicians were divided equally among all 3 biologics (P = 0.011). The results were influenced by geographical location of the physician but not by the gender or length of practice. Furthermore, physicians differed in dosing regimen selection with the majority (73%) choosing treat and extend for patients, whereas only 63% selected this regimen for themselves (P = 0.004). CONCLUSION:: When considering cases of exudative age-related macular degeneration, physicians would recommend different treatments for themselves than they would for a patient.