Purpose: To report a case of polypoidal choroidal vasculopathy (PCV) recalcitrant to treatment with ranibizumab and with a ranibizumab port delivery system (Susvimo) but responsive to faricimab-svoa. Methods: A case and its findings were analyzed. Results: A 69-year-old Filipino man with PCV in the left eye was treated for 2 years with multiple ranibizumab intravitreal (IVT) injections followed by ranibizumab port delivery combined with rescue ranibizumab IVT injections, with no significant response clinically or on imaging. The visual acuity (VA) worsened to 20/100 OD. IVT treatment was switched to faricimab-svoa injections. After 2 injections, there was significant improvement on optical coherence tomography and in VA (20/60). Conclusions: This case shows the potential therapeutic benefits of targeting angiopoietin-2 in addition to vascular endothelial growth factor to treat PCV refractory to ranibizumab. Faricimab may provide an alternative to therapy with ranibizumab and verteporfin photodynamic therapy for the treatment of PCV.
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