Rothbächer Jan, Khalil Haidar, Eidherr Markus, Bolz Matthias
Johannes Kepler University, Linz, Austria.
Department of Ophthalmology and Optometry, Kepler University Hospital, Linz, Austria.
Clin Ophthalmol. 2025 Sep 3;19:3145-3152. doi: 10.2147/OPTH.S530355. eCollection 2025.
To assess how transitioning from an Aflibercept to a Faricimab intravitreal treatment impacts retinal structures and functional aspects in patients with neovascular age related macular degeneration (nAMD) in a real-life setting.
A retrospective clinical study including 49 patients (57 eyes) with nAMD at the Department of Ophthalmology and Optometry, Kepler University Hospital, Linz, Austria was performed. The patients, who had previously been receiving monthly Aflibercept injections with an unsatisfactory treatment response, were switched to intravitreal Faricimab and followed-up between 12/2022 and 12/2023.
The mean treatment-interval before the fifth injection with Faricimab was 5.35 ± 1.49 weeks and was therefore significantly longer compared to the monthly interval with Aflibercept (. Mean baseline central retinal thickness (CRT) was 267.82 ± 76.00 µm and decreased significantly already at month 1 to 249.61 ± 65.35 µm (). After the fourth intravitreal injection, there was no significant change with a CRT of 252.95 ± 56.96 µm (.134). There was a significant reduction in the number of patients showing subretinal fluid (SRF) and intraretinal fluid (IRF). In eyes with fibrovascular pigment epithelium detachment (PED), an interval extension was not possible in more than half of the cases. Eyes with serous and drusenoid PED and a rather high amount of hyper-reflective foci (HRF), the majority showed a significant response after the switch.
An initial loading dose could be beneficial to elongate Faricimab's additional effect of reducing retinal swelling in eyes with nAMD and previous low-response to Aflibercept. Serous and drusenoid PEDs seem to benefit more than fibrovascular PEDs. A high amount of intraretinal HRF in patients with PED was a sign for good respondence to Faricimab.
评估在现实环境中，从阿柏西普转换为法西单抗玻璃体内注射治疗对新生血管性年龄相关性黄斑变性（nAMD）患者视网膜结构和功能方面的影响。
在奥地利林茨开普勒大学医院眼科和验光科进行了一项回顾性临床研究，纳入49例（57只眼）nAMD患者。这些患者之前每月接受阿柏西普注射，但治疗反应不理想，随后改用玻璃体内注射法西单抗，并在2022年12月至2023年12月期间进行随访。
法西单抗第五次注射前的平均治疗间隔为5.35±1.49周，因此与每月注射阿柏西普的间隔相比显著更长（）。平均基线中心视网膜厚度（CRT）为267.82±76.00μm，在第1个月时已显著降至249.61±65.35μm（）。第四次玻璃体内注射后，CRT为252.95±56.96μm，无显著变化（.134）。视网膜下液（SRF）和视网膜内液（IRF）患者数量显著减少。在纤维血管性色素上皮脱离（PED）的眼中，超过半数病例无法延长间隔时间。在浆液性和玻璃膜疣样PED以及相当数量的高反射灶（HRF）的眼中，大多数在转换治疗后有显著反应。
初始负荷剂量可能有利于延长法西单抗对nAMD且先前对阿柏西普反应不佳的眼睛减少视网膜肿胀的附加效果。浆液性和玻璃膜疣样PED似乎比纤维血管性PED受益更多。PED患者视网膜内大量HRF是对法西单抗良好反应的标志。
