Optical Coherence Tomography Angiography Flow Signal in Non-Treatment-Naïve Patients with Neovascular Age-Related Macular Degeneration Treated with Faricimab

<i>Background and Objectives:</i> Age-related macular degeneration (AMD) remains a leading cause of legal blindness. Anti-Vascular Endothelial Growth Factor (VEGF) agents are the first-line treatment for neovascular AMD (nAMD). The choroid plays a key role in AMD and is affected by the a...

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Main Authors: Max Brinkmann, Tom Müller, Marco Köster, Jakob Schweighofer, Mathis Danckwardt, Giuseppe Giannaccare, Paola Marolo, Enrico Borrelli, Michele Reibaldi, Yosuf El-Shabrawi, Mario Damiano Toro
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Language:English
Published: MDPI AG 2025-02-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/2/260
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author Max Brinkmann
Tom Müller
Marco Köster
Jakob Schweighofer
Mathis Danckwardt
Giuseppe Giannaccare
Paola Marolo
Enrico Borrelli
Michele Reibaldi
Yosuf El-Shabrawi
Mario Damiano Toro
author_facet Max Brinkmann
Tom Müller
Marco Köster
Jakob Schweighofer
Mathis Danckwardt
Giuseppe Giannaccare
Paola Marolo
Enrico Borrelli
Michele Reibaldi
Yosuf El-Shabrawi
Mario Damiano Toro
author_sort Max Brinkmann
collection DOAJ
description <i>Background and Objectives:</i> Age-related macular degeneration (AMD) remains a leading cause of legal blindness. Anti-Vascular Endothelial Growth Factor (VEGF) agents are the first-line treatment for neovascular AMD (nAMD). The choroid plays a key role in AMD and is affected by the anti-VEGF treatment. Faricimab, a bispecific antibody additionally targeting angiopoietin 2 (Ang2), was recently approved for nAMD treatment. This study investigates the effect of Faricimab on choroidal flow signal. <i>Materials and Methods:</i> Optical coherence tomography angiography images of 29 nAMD eyes were examined retrospectively. Patients had received treatment with other anti-VEGF agents before Faricimab application. The flow signal in the choroid was measured before, after one and after a series of ≥2 Faricimab injections. <i>Results:</i> The flow signal decreased significantly (<i>p</i> = 0.026) at the choriocapillaris (CC) level after ≥2 injections. The flow signal did not show a significant change in Haller’s layer but increased slightly in Sattler’s layer (<i>p</i> = 0.034). <i>Conclusions:</i> In conclusion, our results show that the flow signal, especially at the CC level, changed during treatment. Despite the known influence of anti-VEGF treatment on the choroid, auxiliary inhibition of Ang2 might enhance this effect. Due to the retrospective nature, moderate sample size and non-treatment, naïve patients, care must be taken while interpreting our observations. Prospective studies with larger sample sizes and treatment-naïve patients will be needed.
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spelling doaj-art-e79ae1f2fae3423da8ab122f1baa7ce62025-08-20T02:04:06ZengMDPI AGMedicina1010-660X1648-91442025-02-0161226010.3390/medicina61020260Optical Coherence Tomography Angiography Flow Signal in Non-Treatment-Naïve Patients with Neovascular Age-Related Macular Degeneration Treated with FaricimabMax Brinkmann0Tom Müller1Marco Köster2Jakob Schweighofer3Mathis Danckwardt4Giuseppe Giannaccare5Paola Marolo6Enrico Borrelli7Michele Reibaldi8Yosuf El-Shabrawi9Mario Damiano Toro10Department of Ophthalmology, Klinikum Klagenfurt, 9020 Klagenfurt, AustriaDepartment of Ophthalmology, Klinikum Klagenfurt, 9020 Klagenfurt, AustriaFaculty of Medicine, Medical University of Graz, 8010 Graz, AustriaDepartment of Ophthalmology, Universitätsklinikum Wiener Neustadt, 1090 Vienna, AustriaDepartment of Ophthalmology, Universitätsklinikum Schleswig-Holstein, 23564 Lübeck, GermanyEye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, ItalyDepartment of Ophthalmology, University of Turin, 10126 Turin, ItalyDepartment of Ophthalmology, University of Turin, 10126 Turin, ItalyDepartment of Ophthalmology, University of Turin, 10126 Turin, ItalyDepartment of Ophthalmology, Klinikum Klagenfurt, 9020 Klagenfurt, AustriaEye Clinic, Public Health Department, University of Naples Federico II, 80133 Naples, Italy<i>Background and Objectives:</i> Age-related macular degeneration (AMD) remains a leading cause of legal blindness. Anti-Vascular Endothelial Growth Factor (VEGF) agents are the first-line treatment for neovascular AMD (nAMD). The choroid plays a key role in AMD and is affected by the anti-VEGF treatment. Faricimab, a bispecific antibody additionally targeting angiopoietin 2 (Ang2), was recently approved for nAMD treatment. This study investigates the effect of Faricimab on choroidal flow signal. <i>Materials and Methods:</i> Optical coherence tomography angiography images of 29 nAMD eyes were examined retrospectively. Patients had received treatment with other anti-VEGF agents before Faricimab application. The flow signal in the choroid was measured before, after one and after a series of ≥2 Faricimab injections. <i>Results:</i> The flow signal decreased significantly (<i>p</i> = 0.026) at the choriocapillaris (CC) level after ≥2 injections. The flow signal did not show a significant change in Haller’s layer but increased slightly in Sattler’s layer (<i>p</i> = 0.034). <i>Conclusions:</i> In conclusion, our results show that the flow signal, especially at the CC level, changed during treatment. Despite the known influence of anti-VEGF treatment on the choroid, auxiliary inhibition of Ang2 might enhance this effect. Due to the retrospective nature, moderate sample size and non-treatment, naïve patients, care must be taken while interpreting our observations. Prospective studies with larger sample sizes and treatment-naïve patients will be needed.https://www.mdpi.com/1648-9144/61/2/260FaricimabchoroidOCTAanti-VEGFangiopoietin 2AMD
spellingShingle Max Brinkmann
Tom Müller
Marco Köster
Jakob Schweighofer
Mathis Danckwardt
Giuseppe Giannaccare
Paola Marolo
Enrico Borrelli
Michele Reibaldi
Yosuf El-Shabrawi
Mario Damiano Toro
Optical Coherence Tomography Angiography Flow Signal in Non-Treatment-Naïve Patients with Neovascular Age-Related Macular Degeneration Treated with Faricimab
Medicina
Faricimab
choroid
OCTA
anti-VEGF
angiopoietin 2
AMD
title Optical Coherence Tomography Angiography Flow Signal in Non-Treatment-Naïve Patients with Neovascular Age-Related Macular Degeneration Treated with Faricimab
title_full Optical Coherence Tomography Angiography Flow Signal in Non-Treatment-Naïve Patients with Neovascular Age-Related Macular Degeneration Treated with Faricimab
title_fullStr Optical Coherence Tomography Angiography Flow Signal in Non-Treatment-Naïve Patients with Neovascular Age-Related Macular Degeneration Treated with Faricimab
title_full_unstemmed Optical Coherence Tomography Angiography Flow Signal in Non-Treatment-Naïve Patients with Neovascular Age-Related Macular Degeneration Treated with Faricimab
title_short Optical Coherence Tomography Angiography Flow Signal in Non-Treatment-Naïve Patients with Neovascular Age-Related Macular Degeneration Treated with Faricimab
title_sort optical coherence tomography angiography flow signal in non treatment naive patients with neovascular age related macular degeneration treated with faricimab
topic Faricimab
choroid
OCTA
anti-VEGF
angiopoietin 2
AMD
url https://www.mdpi.com/1648-9144/61/2/260
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