Charles C. Wykoff, MD, highlights both the success and the limitations of current treatments for wet AMD. While anti-VEGF therapies are effective at controlling bleeding and leakage in the retina, the burden of frequent, indefinite eye injections is unsustainable for many patients. Real-world data show a significant drop-off in treatment adherence over time, undermining outcomes. Wykoff emphasizes the need for more durable solutions, such as gene therapy, which could provide long-term intraocular anti-VEGF production with a one-time treatment. Though challenging to achieve, such advances could reduce patient burden and improve results. Cost remains a concern, but patient safety and efficacy take priority.