Morphologic Changes of Macular Choroidal Neovascularization on OCT Angiography Following Faricimab Therapy in Patients With AMD

Purpose: To describe morphologic changes on optical coherence tomography angiography (OCTA) in 4 eyes with exudative neovascular age-related macular degeneration (nAMD) after a switch in treatment from aflibercept to faricimab. Methods: A total of 4 eyes from 3 patients were evaluated. Results: Three patients (4 eyes) with nAMD were included. Treatment was switched to faricimab due to inadequate control of exudation or limited treatment interval extension with other antivascular endothelial growth factor (anti-VEGF) therapies. All eyes showed morphologic changes in macular neovascularization (MNV) on OCTA after the switch from aflibercept to faricimab. The MNV trunk persisted in all eyes, with regression of the lacy vasculature after treatment. Despite residual MNV, exudation was well controlled in all eyes at 9- to 11-week treatment intervals. Notably, morphologic changes were seen on OCTA even when structural findings remained largely unchanged. Conclusions: Long-term faricimab therapy is associated with distinct morphologic changes in MNV seen on OCTA that were not observed with other anti-VEGF therapies, highlighting the added value of OCTA for assessing treatment response.