Switching to faricimab from aflibercept during maintenance treatment period for age-related macular degeneration

To compare the short-term treatment outcomes of aflibercept and faricimab for neovascular age-related macular degeneration (nAMD) during the maintenance treatment period, we included 82 eyes of 74 patients who switched from aflibercept to faricimab between July 2022 and July 2023, when approximately 80% of the patients with nAMD received faricimab treatment. Visual acuity and retinal exudative changes in the macular and subfoveal areas were evaluated over three months following a single injection of either aflibercept or faricimab. Faricimab resulted in a longer period of significant reduction in retinal exudative changes than aflibercept, whereas visual acuity remained stable with either treatment. Visual acuity analysis, divided by nAMD subtype and the presence of pachychoroid, indicated no clinically significant differences between aflibercept and faricimab. However, faricimab showed stronger fluid suppression in patients with nAMD without pachychoroid, with significant suppression of macular and subfoveal fluids, especially in the intraretinal fluid. These findings suggest that faricimab may be more effective than aflibercept in controlling retinal exudative changes in nAMD during maintenance treatment, particularly in patients without pachychoroid.