VEGFA and age-related macular degeneration: The involvement of systemic immune activation in AMD pathogenesis was further supported by a study from Nussenblatt et al. 25 which showed that systemic immune suppression could alter the clinical course of nAMD and in some cases could reduce the monthly rate of intravitreal anti-VEGF injections to control disease progression when compared to pre-study injection rates or to injection rate in the control group.