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Purpose <p>To evaluate the real-world outcomes of switching to aflibercept 8&#xa0;mg or faricimab in patients with neovascular age-related macular degeneration (nAMD) who showed resistance to aflibercept 2&#xa0;mg.</p> Methods <p>This retrospective chart review included 159 patients with refractory nAMD who had received at least three consecutive injections of aflibercept 2&#xa0;mg at 4–6-week intervals before switching therapy. Patients who showed resistance to aflibercept 2&#xa0;mg were switched to faricimab or aflibercept 8&#xa0;mg between February 2024 and January 2025. After switching, assessments included best-corrected visual acuity (BCVA), central retinal thickness (CRT), choroidal thickness, maximum height and width of pigment epithelial detachment (PED), choroidal vascularity index (CVI), and the presence of intraretinal or subretinal fluid (IRF/SRF).</p> Results <p>Over six months, mean BCVA and CRT did not show a significant difference between aflibercept 8&#xa0;mg group (<i>n</i> = 78) and the faricimab group (<i>n</i> = 81). At month 6, the faricimab group demonstrated significant reductions in CRT, subfoveal choroidal thickness (SFCT), Haller layer thickness, and maximum PED height, whereas the aflibercept 8&#xa0;mg group did not show significant changes in these parameters. CVI increased significantly after switching to faricimab, whereas no significant change was observed after switching to aflibercept 8&#xa0;mg. In addition, a lower proportion of eyes with IRF and/or SRF was observed in the faricimab group at month 6.</p> Conclusion <p>In nAMD patients resistant to aflibercept 2&#xa0;mg, aflibercept 8&#xa0;mg and faricimab achieved similar BCVA and CRT outcomes. However, faricimab induced greater anatomical changes, characterized by larger reductions in PED height and Haller layer thickness, improved fluid resolution, and a greater increase in CVI. These findings suggest that faricimab may provide additional anatomical benefits, particularly in choroidal structural parameters, in aflibercept 2&#xa0;mg-resistant nAMD.</p>

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Comparative outcomes of aflibercept 8 mg and faricimab in neovascular AMD refractory to aflibercept 2 mg

  • 期刊论文

  • 发表日期：

    2026年7月22日

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  • Areum Jeong,
  • Seung Chul Baek,
  • Min Sagong

摘要

Purpose

To evaluate the real-world outcomes of switching to aflibercept 8 mg or faricimab in patients with neovascular age-related macular degeneration (nAMD) who showed resistance to aflibercept 2 mg.

Methods

This retrospective chart review included 159 patients with refractory nAMD who had received at least three consecutive injections of aflibercept 2 mg at 4–6-week intervals before switching therapy. Patients who showed resistance to aflibercept 2 mg were switched to faricimab or aflibercept 8 mg between February 2024 and January 2025. After switching, assessments included best-corrected visual acuity (BCVA), central retinal thickness (CRT), choroidal thickness, maximum height and width of pigment epithelial detachment (PED), choroidal vascularity index (CVI), and the presence of intraretinal or subretinal fluid (IRF/SRF).

Results

Over six months, mean BCVA and CRT did not show a significant difference between aflibercept 8 mg group (n = 78) and the faricimab group (n = 81). At month 6, the faricimab group demonstrated significant reductions in CRT, subfoveal choroidal thickness (SFCT), Haller layer thickness, and maximum PED height, whereas the aflibercept 8 mg group did not show significant changes in these parameters. CVI increased significantly after switching to faricimab, whereas no significant change was observed after switching to aflibercept 8 mg. In addition, a lower proportion of eyes with IRF and/or SRF was observed in the faricimab group at month 6.

Conclusion

In nAMD patients resistant to aflibercept 2 mg, aflibercept 8 mg and faricimab achieved similar BCVA and CRT outcomes. However, faricimab induced greater anatomical changes, characterized by larger reductions in PED height and Haller layer thickness, improved fluid resolution, and a greater increase in CVI. These findings suggest that faricimab may provide additional anatomical benefits, particularly in choroidal structural parameters, in aflibercept 2 mg-resistant nAMD.