ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Comparative outcomes of aflibercept 8 mg and faricimab in neovascular AMD refractory to aflibercept 2 mg.
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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Abstract
purposeTo 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.
methodsThis 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).
resultsOver 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.
conclusionIn 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.
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