Abstract
Purpose: To compare functional and morphologic outcomes after loading doses of faricimab and high-dose aflibercept for treatment-naive neovascular age-related macular degeneration (nAMD). Methods: We retrospectively enrolled 62 consecutive patients (64 eyes) with nAMD whose initial visual acuity (VA) was ≤20/25. Patients received 3 consecutive monthly loading doses of intravitreal 6.0 mg/0.05 mL faricimab (IVF) or intravitreal 8.0 mg/0.07 mL high-dose aflibercept (IVHDA). Changes in best-corrected VA (BCVA) and fluid were assessed at 4, 8, and 16 weeks compared with baseline. Results: Two patients were excluded from the final analysis, yielding a total of 60 patients (62 eyes). In the IVF group (n = 31 eyes), the logMAR BCVAs at baseline, 4, 8, and 16 weeks were 0.40, 0.35, 0.33, and 0.30, respectively; significant improvement occurred at 16 weeks only (P = .004 vs baseline). In the IVHDA group (n = 31 eyes), the logMAR BCVAs at the respective timepoints were 0.44, 0.36, 0.30, and 0.32; significant improvements occurred at 8 and 16 weeks (P = .001 and P = .007, respectively, vs baseline). At 16 weeks, 90.3% of patients receiving IVF and 80.6% receiving IVHDA had dry macula (P = .473). Conclusion: Significant BCVA improvements were achieved with both treatments, although improvement was faster with IVHDA. High rates of dry macula were achieved at 16 weeks in more patients in the IVF group than in the IVHDA group.