ArticleOphthalmology and therapy2026
Real-World Outcomes of Faricimab in Patients with Highly Refractory Neovascular Age-Related Macular Degeneration in Portugal: The REVEAL Study.
Article in Ophthalmology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionManagement of highly refractory exudative neovascular age-related macular degeneration (nAMD) remains challenging when multiple antivascular endothelial growth factor (VEGF) therapies fail to control the disease. Faricimab, through dual inhibition of VEGF-A and angiopoietin-2, may represent a potential therapeutic alternative for this difficult-to-treat population. However, real-world evidence in highly refractory nAMD remains limited and is lacking in the Portuguese population.
methodsThis multicenter, retrospective, real-world study included patients with nAMD highly refractory to previous anti-VEGF therapies who were treated with faricimab and followed for at least 6 months. Functional and anatomical outcomes were assessed, including changes in best-corrected visual acuity (BCVA), central subfield thickness (CST), and evolution of intraretinal fluid (IRF) and subretinal fluid (SRF).
resultsA total of 46 eyes from 40 patients were included, characterized by a long-standing disease (median [25th percentile (P25); 75th percentile (P75)] duration, 5.0 [3.0; 6.0] years) and a high prior treatment burden (32.0 [24.0; 45.8] anti-VEGF injections and median treatment interval of 4.0 [4.0; 6.0] weeks). After faricimab, functional stability was observed (median change in BCVA of 0.0 [-0.1; 0.1] logMAR). Anatomical outcomes showed improvement, with a median reduction in CST of -12 [-58; 7] µm and complete SRF resolution in 47.8% of eyes. Median treatment intervals of 8.0 [6.0-10.0] weeks were achieved, representing a twofold increase in the median treatment interval.
conclusionsIn this real-world study of highly refractory nAMD, faricimab was associated with stabilization of functional outcomes and improvement in anatomical outcomes over short- to mid-term follow-up, alongside a twofold increase in treatment-interval length in routine clinical practice. These findings support the clinical relevance of inhibiting angiopoietin-2 (Ang-2) and represent the first evaluation conducted in routine clinical practice in Portugal, with potential implications for treatment burden and patient adherence.
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