Real-Life 1-Year Results and Predictors of Visual Outcome with Intravitreal Faricimab for Treatment of Exudative Neovascular Age-Related Macular Degeneration

The purpose of this study was to report 1-year real-world outcomes of faricimab for the treatment of macular neovascularization secondary to age-related macular degeneration (nAMD). Early predictors of functional outcome were investigated. This was a retrospective, longitudinal study including 132 eyes with nAMD (27% treatment-naïve, 73% switchers) treated with faricimab following a treat-and-extend protocol. Primary outcomes were best-corrected visual acuity (BCVA) and central macular thickness (CMT) changes at 1-year follow-up. Secondary outcomes included possible early predictors of 1-year functional outcomes. Early predictors were investigated at the baseline and after the loading phase. After the loading phase, both BCVA (from 0.40 ± 0.33 to 0.35 ± 0.34 LogMAR) and CMT (from 403 ± 135 to 317 ± 108 um) improved significantly (p = 0.014 and p > 0.001 respectively). At 1 year, only CMT reduced significantly (from 403 ± 135 to 317 ± 114 um, p < 0.001), and 36% of eyes were defined as good visual responders (≥ 5 ETDRS letters gain). Predictors of good response were lower BCVA and absence of type 3 macular neovascularization (MNV) at baseline and lower CMT after loading phase. Approximately 60% of patients achieved ≥ Q12-week dosing. Treatment-naïve patients achieved higher extension rates (82% ≥ Q12). No cases of intraocular inflammation were observed. In our real-world practice, faricimab effectively controls nAMD, offering significant anatomical benefits and visual stability with extended dosing intervals. Approximately 80% of treatment-naïve patients maintained ≥ Q12-week schedules. Early anatomical response, defined by reduction in CMT and absence of exudative signs on structural optical coherence tomography (OCT), emerged as a clinically relevant prognostic factor for 1-year outcomes. This study looked at how faricimab works in everyday clinical practice for people with neovascular age-related macular degeneration. We reviewed the records of 132 patients treated at a specialist eye center over 1 year, including people who had never received injections before and others who switched from previous treatments. We measured functional and anatomical parameters to see how the disease changed over time and to find early signs that could predict who would benefit most. Overall, many patients showed improvement. Many patients were also able to extend the time between injections, reducing treatment burden. Better starting vision and early reduction of fluid in the retina were linked to better outcomes in terms of visual acuity, while patients with type 3 macular neovascularization was linked to poorer visual improvement. The results suggest that faricimab can be effective and long-lasting in real-world patients, especially when the eye responds quickly early in treatment, but longer and larger studies are needed to confirm these findings.