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Purpose <p>To investigate morphological changes in macular neovascularization (MNV) using optical coherence tomography angiography (OCTA) and identify imaging biomarkers associated with treatment responsiveness to faricimab in patients with neovascular age-related macular degeneration (nAMD).</p> Methods <p>This prospective study investigated consecutive eyes of patients with treatment-naïve nAMD who were treated with faricimab. After 3-monthly loading doses, the patients received a fixed 8-, 12-, or 16-week treatment regimen (Q8W/Q12W/Q16W) and were grouped as poor responders (Q8W/Q12W) or good responders (Q16W). Dosing interval determination depended on disease activity post-loading phase. Baseline and 14-month quantitative OCTA parameters were analyzed.</p> Results <p>Forty-four eyes (pure type 1 MNV: 35 eyes, mixed type 1 and type 2 MNV: 9 eyes) were analyzed. The visual acuity (<i>P</i> &lt; 0.001) and central retinal thickness (<i>P</i> &lt; 0.0001) significantly improved post-faricimab treatment from baseline to Month 14. In mixed type 1 and type 2 MNV, total vessel length decreased from baseline to Month 14 (<i>P</i> &lt; 0.05), whereas vessel area did not significantly change (<i>P</i> = 0.11). No significant changes in total vessel length or vessel area were detected in pure type 1 MNV (<i>P</i> = 0.23 and <i>P</i> = 0.30, respectively). In the subgroup of type 1 MNV, a significant decrease in endpoint density was observed only in good responders (<i>P</i> = 0.04), with no corresponding change in poor responders.</p> Conclusion <p>A fixed faricimab regimen through Month 14 was associated with improved visual and anatomical outcomes in treatment-naïve nAMD. OCTA-based vascular changes differed according to MNV type and treatment responsiveness. In pure type 1 MNV, endpoint density may be a potential OCTA-based biomarker associated with treatment responsiveness, contributing to a more personalized therapeutic approach for nAMD.</p>

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Association between angiogenic features and responsiveness to faricimab in treatment-naïve neovascular age-related macular degeneration with OCT angiography

  • 期刊论文

  • 发表日期：

    2026年7月6日

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  • Ryosuke Sakai,
  • Ai Ichioka,
  • Midori Ideyama,
  • Masahiro Akada,
  • Naoko Ueda-Arakawa,
  • Ai Kido,
  • Ayako Takahashi,
  • Masahiro Miyake,
  • Yuki Muraoka,
  • Manabu Miyata,
  • Hiroshi Tamura,
  • Sotaro Ooto,
  • Akitaka Tsujikawa,
  • Masayuki Hata

摘要

Purpose

To investigate morphological changes in macular neovascularization (MNV) using optical coherence tomography angiography (OCTA) and identify imaging biomarkers associated with treatment responsiveness to faricimab in patients with neovascular age-related macular degeneration (nAMD).

Methods

This prospective study investigated consecutive eyes of patients with treatment-naïve nAMD who were treated with faricimab. After 3-monthly loading doses, the patients received a fixed 8-, 12-, or 16-week treatment regimen (Q8W/Q12W/Q16W) and were grouped as poor responders (Q8W/Q12W) or good responders (Q16W). Dosing interval determination depended on disease activity post-loading phase. Baseline and 14-month quantitative OCTA parameters were analyzed.

Results

Forty-four eyes (pure type 1 MNV: 35 eyes, mixed type 1 and type 2 MNV: 9 eyes) were analyzed. The visual acuity (P < 0.001) and central retinal thickness (P < 0.0001) significantly improved post-faricimab treatment from baseline to Month 14. In mixed type 1 and type 2 MNV, total vessel length decreased from baseline to Month 14 (P < 0.05), whereas vessel area did not significantly change (P = 0.11). No significant changes in total vessel length or vessel area were detected in pure type 1 MNV (P = 0.23 and P = 0.30, respectively). In the subgroup of type 1 MNV, a significant decrease in endpoint density was observed only in good responders (P = 0.04), with no corresponding change in poor responders.

Conclusion

A fixed faricimab regimen through Month 14 was associated with improved visual and anatomical outcomes in treatment-naïve nAMD. OCTA-based vascular changes differed according to MNV type and treatment responsiveness. In pure type 1 MNV, endpoint density may be a potential OCTA-based biomarker associated with treatment responsiveness, contributing to a more personalized therapeutic approach for nAMD.