Faricimab for Treatment-Naïve nAMD: 1- and 2-Year Outcomes and PS-OCT Polarimetric Entropy

Background: To evaluate 1- and 2-year outcomes of faricimab in treatment-naïve nAMD and assess associations between visual acuity change and PS-OCT–derived polarimetric entropy (PE). Methods: This retrospective single-center study included 27 treatment-naïve nAMD eyes initiating faricimab. All eyes were evaluable at 1 year (n = 27) and 18 at 2 years (n = 18). BCVA (logMAR), central retinal thickness (CRT), PE, and hyperreflective foci (HRF) metrics were assessed. Multivariable linear regression with stepwise selection evaluated factors associated with ΔlogMAR (post − pre). Results: BCVA improved from 0.40 ± 0.28 to 0.20 ± 0.23 at 1 year (P < 0.0001). In the 2-year cohort, BCVA improved from 0.35 ± 0.28 to 0.15 ± 0.20 at 1 year (P = 0.0003) and 0.12 ± 0.17 at 2 years (P = 0.0004). CRT decreased from 337.3 ± 185.9 µm to 186.7 ± 47.3 µm at 1 year (P < 0.0001) and from 337.5 ± 159.8 µm to 185.1 ± 46.4 µm at 1 year (P = 0.0019) and 181.2 ± 60.9 µm at 2 years (P < 0.0001). Mean PE increased at 1 year (0.44 ± 0.06 to 0.46 ± 0.05; P < 0.0001) but not from baseline to 2 years (P = 0.81). HRF metrics decreased after treatment. In multivariable analyses, PE change was independently associated with 1-year ΔlogMAR (β=−2.79, 95%CI − 4.39 to − 1.18; P = 0.0015) along with MNV subtype (Type 2 vs Type 1: β=−0.08, 95%CI − 0.13 to − 0.02; P = 0.0108). For 2-year ΔlogMAR, PE change (β=−2.18, 95%CI − 4.30 to − 0.065; P = 0.044) and CRT change (β=−0.00072, 95%CI − 0.00124 to − 0.00019; P = 0.0107) were independently associated. Conclusions: Faricimab was associated with sustained functional and anatomical improvement, and within-eye PE increases were independently associated with greater visual improvement.