Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
Sub-retinal pigment epithelium features as predictors for limited interval extension of faricimab in treatment-naïve neovascular age-related macular degeneration.
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Kataoka Keiko, Watanabe Yuto, Kumagai Mariko, Ko Rie, Yamamoto Akiko, Okada Annabelle A
Аннотация
PURPOSE: To explore subtypes of macular neovascularization (MNV) and anatomical features predictive for limited interval extension of faricimab injections in treatment-naïve neovascular age-related macular degeneration (nAMD).
METHODS: This retrospective study evaluated 82 eyes of 78 patients initiating treatment with faricimab using a treat-and-extend regimen. Age and best-corrected visual acuity (BCVA) were extracted from medical records. Optical coherence tomography parameters including central retinal thickness (CRT), subfoveal choroidal thickness (SFCT), and maximum pigment epithelial detachment (PED) height were measured.
RESULTS: At one year, 63 eyes (76.8%) continued faricimab treatment, while 19 eyes (23.2%) discontinued due to inability to maintain ≥ 8-week intervals. Discontinued eyes exhibited significantly greater baseline maximum PED height (P = 0.012). Eyes achieving intervals ≥ 12 weeks (extended group, n = 40) were compared with those not achieving this criterion (non-extended group, n = 42). Post hoc residual analysis revealed that type 1 MNV without polypoidal lesions was significantly overrepresented in the non-extended group (P = 0.033). Multivariable logistic regression analysis confirmed that greater baseline maximum PED height was the only independent predictor of limited interval extension (odds ratio, 0.965 per 10-µm increase; 95% confidence interval, 0.935-0.995; P = 0.021). Other baseline factors, including age, BCVA, CRT, and SFCT, showed no significant association.
CONCLUSION: Sub-RPE features at baseline, specifically type 1 MNV without polypoidal lesions and greater PED height, are significant predictors of limited treatment interval extension in treatment-naïve nAMD eyes receiving faricimab. Recognizing these features prior to treatment initiation may guide clinical decision-making regarding injection frequency.
METHODS: This retrospective study evaluated 82 eyes of 78 patients initiating treatment with faricimab using a treat-and-extend regimen. Age and best-corrected visual acuity (BCVA) were extracted from medical records. Optical coherence tomography parameters including central retinal thickness (CRT), subfoveal choroidal thickness (SFCT), and maximum pigment epithelial detachment (PED) height were measured.
RESULTS: At one year, 63 eyes (76.8%) continued faricimab treatment, while 19 eyes (23.2%) discontinued due to inability to maintain ≥ 8-week intervals. Discontinued eyes exhibited significantly greater baseline maximum PED height (P = 0.012). Eyes achieving intervals ≥ 12 weeks (extended group, n = 40) were compared with those not achieving this criterion (non-extended group, n = 42). Post hoc residual analysis revealed that type 1 MNV without polypoidal lesions was significantly overrepresented in the non-extended group (P = 0.033). Multivariable logistic regression analysis confirmed that greater baseline maximum PED height was the only independent predictor of limited interval extension (odds ratio, 0.965 per 10-µm increase; 95% confidence interval, 0.935-0.995; P = 0.021). Other baseline factors, including age, BCVA, CRT, and SFCT, showed no significant association.
CONCLUSION: Sub-RPE features at baseline, specifically type 1 MNV without polypoidal lesions and greater PED height, are significant predictors of limited treatment interval extension in treatment-naïve nAMD eyes receiving faricimab. Recognizing these features prior to treatment initiation may guide clinical decision-making regarding injection frequency.