Analysis of Visual and Anatomical Outcomes with Biosimilar Intravitreal Injections for Neovascular Age-related Macular Degeneration: A Retrospective Cohort Study

Purpose: To evaluate the anatomical and visual effects of biosimilars in the treatment of wet age-related macular degeneration (AMD).Methods: We retrospectively reviewed patients with wet AMD treated with originator or biosimilar ranibizumab (CKD-701) or aflibercept (SB15) between June 2024 and February 2025 at Severance Eye Hospital.Clinical outcomes were assessed over six months using best corrected visual acuity (BCVA) and central macular thickness (CMT) measurements.Results: Among 272 patients, 91 received ranibizumab (54.9% originator, 45.1% biosimilar) and 181 received aflibercept (66.9% originator, 33.1% biosimilar).In the ranibizumab group, BCVA and CMT improvements were comparable between originator and biosimilar formulations, with no significant differences in injection number.In the aflibercept group, the biosimilar cohort received significantly fewer injections (3.63 [originator] vs. 3.11 [biosimilar], p = 0.006) and showed slightly inferior visual and anatomical outcomes, likely influenced by a smaller proportion of treatment-nave patients and limited insurance coverage.No serious adverse events were observed in any group.Conclusions: Biosimilars demonstrated acceptable efficacy and safety over six months.Broader use could improve accessibility, though further long-term data are needed.