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Evaluate effects of switching to Faricimab in neovascular AMD patients despite previous treatment failures.

March 28, 2026Clinical ophthalmology0 citationsOpen Access

Real-World Outcomes of Switching to Faricimab in Treatment-Experienced and Resistant Neovascular Age-Related Macular Degeneration: A Single-Centre Retrospective Study

CSChristopher M. StewartEmory University JBJaskaran Singh BhanguSwansea Bay University Health Board PSParinita SwarnkarSwansea Bay University Health Board

Key Points

Evaluate effects of switching to Faricimab in neovascular AMD patients despite previous treatment failures.
Retrospective study of 67 eyes switched to Faricimab.
Patients received three monthly loading doses followed by a treat-and-extend regimen.
Primary outcomes included central macular thickness and best-corrected visual acuity.
Statistically significant reduction in central macular thickness after eight injections.
43.3% of patients achieved macular dryness by injection three, declining by injection eight.
46.3% of patients achieved a treatment interval extension.

Abstract

Purpose: To evaluate anatomical, functional, and treatment burden outcomes of Faricimab in neovascular age-related macular degeneration (nAMD) patients with persistent disease activity despite prior anti-VEGF therapy. Patients and Methods: Single-centre retrospective study of 67 eyes switched to Faricimab (November 2022–December 2024). This cohort was unable to be extended beyond 4– 6-week intervals on existing anti-VEGF therapy. All patients received three monthly loading doses followed by treat-and-extend regimen. Primary outcomes: central macular thickness (CMT), best-corrected visual acuity (BCVA), macular dryness over eight injections, and treatment interval extension. Results: The cohort had received mean 33 (range 10– 78) prior anti-VEGF. Baseline mean BCVA was 0.42 logMAR (SD ± 0.28) and mean CMT was 244.5 μm (SD ± 62.2). Statistically significant CMT reduction occurred by injection 8 (− 16.9 μm, p=0.0084). Complete macular dryness peaked by the time of third injection (43.3%) then declined to 32.8% at injection 8 (p=0.0089). Visual acuity remained unchanged (p=0.6043) with no correlation to CMT change (p=0.172). Treatment interval extension was achieved in 46.3% of patients (p=0.002). Dryness at injection 3 after switching to Faricimab did not predict treatment extension (p=0.217). Two patients (0.36% of total injections, 2/548) developed sterile intraocular inflammation requiring discontinuation. Conclusion: Faricimab switching achieves statistically significant but modest anatomical improvement in heavily pretreated nAMD with meaningful treatment burden reduction in 46.3% of eyes. Our analysis revealed treatment burden did not indicate the potential for treatment interval extension. Keywords: Faricimab, anti-VEGF switching, treatment-resistant nAMD, treat-and-extend

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