Short-term Outcomes of Faricimab for Neovascular Age-related Macular Degeneration with Limited Response to Ranibizumab or Aflibercept

Purpose: To evaluate the clinical outcomes of switching to faricimab for patients with neovascular age-related macular degeneration (AMD) demonstrating a limited response to prior anti-vascular endothelial growth factor (VEGF) treatments. Methods: We performed a retrospective analysis of patients with neovascular AMD who had residual subretinal fluid (SRF) or traretinal fluid (IRF) despite treatment with ranibizumab or aflibercept, and who were subsequently treated with faricimab. The study assessed changes in best-corrected visual acuity (logarithm of the minimum angle of resolution) and central retinal thickness (CRT), as well as differences in the incidence of SRF, IRF, and serous retinal pigment epithelial detachment (S-PED) with versus without switching to faricimab. Results: The study included 22 eyes. Mean best-corrected visual acuity improved from 0.31 +/- 0.21 before switching to faricimab to 0.28 +/- 0.19 after the switch (p p = 0.172). CRT significantly decreased from 336.7 +/- 83.3 to 279.9 +/- 51.1 mu m (p p = 0.002). Prior to switching, SRF was noted in 17 patients (94.4%), IRF in 5 (27.8%), and S-PED in 4 (22.2%). Following the switch to faricimab, these figures dropped to 13 (72.2%), 4 (22.2%), and 3 (16.7%), respectively. A complete resolution of retinal edema was achieved in four patients (22.2%) after the treatment switch. Conclusions: Switching to faricimab in patients with neovascular AMD who had a limited response to previous treatments led significant anatomical improvements. Faricimab may be a valuable treatment option for these patients. J Korean Ophthalmol Soc 2024;65(8):515-524