Effect of Faricimab on Visual Acuity and Retinal Structure in Neovascular Age-Related Macular Degeneration Previously Treated With Anti-VEGF Therapy

Abstract

Purpose: To evaluate the effects of switching from traditional anti-vascular endothelial growth factor (anti-VEGF) therapies to faricimab, a bispecific monoclonal antibody that targets both VEGF and angiopoietin-2, on eyes with neovascular age-related macular degeneration (nAMD). Methods: This study retrospectively reviewed patients with nAMD who were previously treated with bevacizumab, ranibizumab, or aflibercept and then switched to faricimab. We compared injection frequency and visual acuity (VA) during the time period before faricimab initiation (1 year prior) and after initiation (6-12 months after). Optical coherence tomography images were analyzed from initiation to final follow-up (6-12 months after initiation). Results: We evaluated 84 eyes of 68 patients. Following faricimab initiation, eyes had a reduced mean ± SE central macular thickness (CMT) (282.3 ± 16.2 μm preinitiation vs 244.8 ± 14.3 μm postinitiation; P < .01). Annual injection frequency increased from 7.73 ± 0.33 to 8.66 ± 0.28 injections (P < .001). VA did not change significantly during the year before faricimab initiation (P = .539) but decreased after initiation (from 0.56 ± 0.05 logMAR to 0.66 ± 0.06 logMAR; P < .01). Four eyes developed macular atrophy following faricimab initiation (P < .01). Conclusions: Eyes with nAMD that were previously treated with anti-VEGF therapy and later switched to faricimab showed reduced CMT; however, some patients had increased injection frequency, decreased VA, and macular atrophy. These findings should be explored further using larger datasets.