Outcomes of Intravitreal Aflibercept 8 mg in Eyes With Neovascular Age-Related Macular Degeneration Previously Treated With Faricimab

Background and Objective To assess the efficacy of intravitreal aflibercept 8 mg in treating neovascular age-related macular degeneration (nAMD) in patients previously treated with faricimab. Patients and Methods A retrospective study was conducted on nAMD patients with suboptimal response to faricimab injections who were switched to intravitreal aflibercept 8 mg. Visual acuity (VA) and optical coherence tomography features were evaluated. Results The study included 135 eyes from 85 patients who received an average of 7.4 (4) faricimab injections with a mean interval of 53 days, which decreased to 48 days by the 5th aflibercept 8 mg injection ( P = 0.056). Mean VA at the time of switch was 63.9 (14.4) letters and was 65 (13.5) letters after four aflibercept 8 mg injections ( P = 0.726). Mean central foveal thickness (CFT) at switch was 325 (104) µm which decreased to 272 (65) after four aflibercept 8 mg injections ( P < 0.001). The incidence of intraretinal fluid and subretinal hemorrhage increased from 31.3% and 8.1% at switch to 52.2% and 21.7% ( P = 0.029 and 0.004), respectively. Conclusions Switching from faricimab to aflibercept 8 mg did not result in interval extension or VA improvement. CFT decreased, but intraretinal fluid and subretinal hemorrhage increased. Further studies are warranted. [ Ophthalmic Surg Lasers Imaging Retina 2025;56:206–211.]