{"doi":"10.1038/s41598-025-09910-2","title":"Faricimab at 6 and 12 mg reduces pigment epithelium detachment in treatment-resistant macular neovascularization: an OCT and AI analysis","abstract":"Macular neovascularization (MNV) in age-related macular degeneration (AMD) remains a therapeutic challenge, especially in eyes resistant to conventional anti-VEGF therapy. This study evaluates the anatomical and functional response to Faricimab in patients with persistent fluid despite intensified Aflibercept treatment and explores potential benefits of dose escalation. This cross-sectional study included 25 eyes from 23 patients with active MNV resistant to standard anti-VEGF therapy. All had persistent fluid on OCT despite monthly injections and received off-label double-volume Aflibercept 4 mg (0.1 ml) for at least three doses. Eyes with persistent fluid were switched to Faricimab 6 mg. In non-responders, Faricimab was further escalated to 12 mg (0.1 ml). Retinal fluid volumes and pigment epithelium detachment (PED) were analyzed using AI-based OCT segmentation. MNV activity was assessed using AI-based OCTA analysis. Faricimab 6 mg significantly reduced PED volume (p < 0.05), especially after the first two injections. However, changes in intraretinal and subretinal fluid were not significant. In the Faricimab 12 mg subgroup, no additional anatomical benefit was observed. OCTA showed a trend toward reduced vascular activity after switching to Faricimab 6 mg, but no further change with dose escalation. In MNV eyes resistant to high-dose Aflibercept, Faricimab 6 mg provides meaningful anatomical improvement, particularly in PED volume. However, escalating Faricimab to 12 mg offers no additional benefit, suggesting therapeutic saturation at the standard dose.","journal":"Scientific Reports","year":2025,"id":576420,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9624,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":215643,"name":"Melanie Tran","orcid":null,"position":1,"is_corresponding":false},{"id":1045317,"name":"Haochen Zhang","orcid":"0000-0002-8292-9491","position":2,"is_corresponding":false},{"id":342574,"name":"Lingyun Cheng","orcid":"0000-0002-0748-5173","position":3,"is_corresponding":false},{"id":949032,"name":"Anna Heinke","orcid":"0000-0002-7115-8767","position":4,"is_corresponding":false},{"id":233337,"name":"Nehal N. Mehta","orcid":"0000-0003-4939-5130","position":5,"is_corresponding":false},{"id":384829,"name":"Dirk‐Uwe Bartsch","orcid":"0000-0003-0955-8708","position":6,"is_corresponding":false},{"id":949031,"name":"Fritz Gerald P. Kalaw","orcid":"0000-0002-3940-2272","position":7,"is_corresponding":false},{"id":865066,"name":"Mohamed A. Morsy","orcid":"0000-0002-6752-9094","position":8,"is_corresponding":false},{"id":933536,"name":"Arthur Mueller","orcid":null,"position":9,"is_corresponding":false},{"id":1386739,"name":"William R. Freeman","orcid":"0000-0001-6382-1218","position":10,"is_corresponding":false},{"id":1235107,"name":"Ines D. Nagel","orcid":"0000-0002-4649-6764","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-19T02:57:56.636458Z","pmid":"41028859","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}