ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
VEGF-inhibitor switch trial in poor-responsive neovascular age-related macular degeneration: assessing brolucizumab vs. faricimab: VISTA study.
Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
purposeTo compare short-term (12 weeks) and long-term (48 weeks) anatomical and functional outcomes after switching to brolucizumab (BRZ) or faricimab (FAR) under a treat-and-extend (TAE) regimen without an initial loading phase in eyes with poor-responsive neovascular age-related macular degeneration (nAMD).
methodsThis retrospective, single-center study included eyes with poor-responsive nAMD previously treated with anti-VEGF agents that were switched to BRZ or FAR between 2022 and 2025. Functional outcomes (best-corrected visual acuity [BCVA]) and anatomical parameters (central subfield thickness [CST], fibrovascular pigment epithelial detachment [fvPED] height, intraretinal/subretinal fluid [IRF/SRF], subretinal hyperreflective material [SHRM]) were assessed at baseline, week 12, and week 48. Injection frequency, interval extension, and safety were recorded.
resultsSixty-six eyes (41 BRZ, 25 FAR) were included. At 12 weeks, BCVA remained stable (BRZ 0.49 logMAR, FAR 0.40; p = 0.10). CST decreased significantly in both groups, greater with BRZ (243 μm vs. 280 μm; p = 0.04). Mean injections (2.95 vs. 3.2; p = 0.12) and intervals (5.9 vs. 5.6 weeks; p = 0.90) were comparable; no intraocular inflammation (IOI) occurred. At 48 weeks, BCVA was numerically better with FAR (0.20 vs. 0.49 logMAR; p = 0.08). CST reduction was sustained andcomparable (259 µm vs. 260 µm; p = 0.50). FAR achieved greater fvPED reduction (110 µm vs. 160 µm; p = 0.022). BRZ required fewer injections (6.3 vs. 7.2; p = 0.009) with similar intervals (9.4 vs. 9.9 weeks; p = 0.80). Mild IOI occurred in two BRZ eyes (4.9%) and none with FAR.
conclusionsIn poor-responsive nAMD, switching to BRZ or FAR under a TAE regimen without upload achieved stable vision, sustained CST reduction, and comparable treatment burden over one year. FAR showed greater fvPED regression and a slight functional trend, while BRZ achieved faster fluid resolution with fewer injections.
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