Khodor Ali, Caranfa Jonathan T, Nanda Tavish, Ruiz-Lozano Raul E, Quiroga-Garza Manuel E, Choi Stephanie, Chehab Ali, Ramos-Dávila Eugenia M, Heier Jeffery S, Shah Chirag P, Witkin Andre J
Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA.
New England Eye Center, Department of Ophthalmology, Tufts University Medical Center, Boston, MA, USA.
Ophthalmol Ther. 2025 Jul 3. doi: 10.1007/s40123-025-01181-4.
To evaluate the outcomes of intravitreal faricimab (IVF; Vabysmo) in previously treated patients with wet age-related macular degeneration (wAMD), focusing on best available visual acuity (BAVA), central subfield thickness (CST), injection interval, complications, fluid resolution, and reversion rates to prior therapies.
The PubMed, Embase, and Google Scholar databases were searched for studies reporting outcomes of treatments for previously treated cases of wAMD. Mean differences (MD) with 95% confidence intervals (CI) were used to compute the effect size of the change in outcomes.
A total of 29 studies with 2070 patients (1003 women, mean age 78.9 years) and 2128 eyes were included. BAVA and CST were reported in 28 studies, fluid status in 21, injection interval in 14, and reversion rates in 6. Pooled analysis showed significant but modest improvement in BAVA when IVF was given for > 6 months (MD = -0.026 LogMAR, p < 0.05) but not at earlier follow-ups. A similar trend was noted with injection interval extension when IVF was given beyond 6 months (MD = +2.1 weeks, p < 0.05). CST reduction was observed at all time points (overall MD = -37.7 μm, p < 0.05). Complication rates were reported in nine studies, with an overall rate of 1.2%, including retinal pigment epithelium tear, intraocular inflammation, endophthalmitis, and subretinal hemorrhage. Reversion to prior or other anti-vascular endothelial growth factor (anti-VEGF) therapy was reported in six studies, occurring in 23% of eyes.
We reported the outcomes of utilizing IVF in previously treated cases of wAMD. IVF showed a significant improvement in CST at all time points and in the extension of injection interval. Visual outcomes remained unchanged when followed for less than 6 months but improved significantly but modestly when followed for more than 6 months. Switching to intravitreal faricimab may be a useful treatment option for previously treated patients with wAMD, with a goal of reducing treatment burden and improving treatment efficacy.
评估玻璃体内注射法西单抗（IVF；Vabysmo）在既往接受过治疗的湿性年龄相关性黄斑变性（wAMD）患者中的治疗效果，重点关注最佳矫正视力（BAVA）、中心子野厚度（CST）、注射间隔、并发症、积液消退情况以及恢复至先前治疗的比例。
检索PubMed、Embase和谷歌学术数据库，查找报告既往接受治疗的wAMD病例治疗效果的研究。采用95%置信区间（CI）的均值差（MD）来计算结局变化的效应量。
共纳入29项研究，涉及2070例患者（1003名女性，平均年龄78.9岁）和2128只眼。28项研究报告了BAVA和CST，21项报告了积液状态，14项报告了注射间隔，6项报告了恢复比例。汇总分析显示，当IVF治疗超过6个月时，BAVA有显著但适度的改善（MD = -0.026 LogMAR，p < 0.05），但在早期随访时未出现改善。当IVF治疗超过6个月时，注射间隔延长也呈现类似趋势（MD = +2.1周，p < 0.05）。在所有时间点均观察到CST降低（总体MD = -37.7μm，p < 0.05）。9项研究报告了并发症发生率，总体发生率为1.2%，包括视网膜色素上皮撕裂、眼内炎症、眼内炎和视网膜下出血。6项研究报告了恢复至先前或其他抗血管内皮生长因子（anti-VEGF）治疗的情况，23%的眼出现这种情况。
我们报告了在既往接受治疗的wAMD病例中使用IVF的治疗效果。IVF在所有时间点均显示CST有显著改善，且注射间隔延长。随访时间少于6个月时视力结局无变化，但随访时间超过6个月时显著但适度改善。对于既往接受治疗的wAMD患者，改用玻璃体内注射法西单抗可能是一种有用的治疗选择，目标是减轻治疗负担并提高治疗效果。
