One-year real-world data of intravitreal faricimab in patients with pre-treated neovascular age-related macular degeneration

Abstract Purpose To assess one-year real-world outcomes of faricimab therapy in patients with neovascular age-related macular degeneration (nAMD) previously treated with anti-VEGF agents and managed using a treat-and-extend (TAE) regimen. Methods Patients with treatment-resistant nAMD were switched to faricimab. Functional and structural parameters, including best-corrected visual acuity (BCVA in logMAR), foveal centre point (FCP in µm), central subfield retinal thickness (CSRT in µm), and macular volume (MV in mm³), were recorded over a one-year observation period. Results Seventy eyes from 59 patients initiated faricimab therapy between September and December 2022; complete one-year data were available for 60 eyes, with a mean follow-up of 391 ± 20 days. Prior to switching, patients had received an average of 42.4 ± 25.2 anti-VEGF injections over 70.8 ± 45.4 months. Significant structural improvements were observed: FCP decreased from 359 ± 165 μm to 283 ± 132 μm, CSRT from 414 ± 153 μm to 343 ± 116 μm, and macular volume from 2.74 ± 0.67 mm³ to 2.46 ± 0.49 mm³ (all p < 0.001). The mean injection interval increased from 5.8 ± 1.8 weeks to 8.2 ± 3.3 weeks ( p < 0.001), indicating improved disease control. BCVA remained stable (0.45 ± 0.37 logMAR vs. 0.44 ± 0.39 logMAR; p = 0.35). At the end of follow-up, 37% of eyes achieved a completely dry macula with no residual intra-, subretinal, or sub-RPE fluid. Two eyes developed mild anterior chamber inflammation, which resolved fully under topical corticosteroids. Conclusion Switching to faricimab in recalcitrant, heavily pretreated nAMD may yield meaningful structural improvements while stabilizing visual acuity.