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Updated: Jul 12, 2026
Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography
Published on: March 26, 2020
Effect of Faricimab on Optical Coherence Tomography Angiography and Artificial Intelligence-Based Analysis in
Mohamed Sherif Morsy1,2, Anna Heinke1,2, Nehal Nailesh Mehta1,2
1Jacobs Retina Center, La Jolla, California, USA.
Introduction:
Treatment-resistant choroidal neovascularization (CNV) remains a major challenge despite anti-VEGF therapy. Faricimab, with dual inhibition of VEGF-A and Ang-2, offers a novel approach. The purpose of this study was to evaluate its effect using advanced OCTA-based vascular analysis and AI-assisted anatomical assessment, providing new insights into therapeutic response in resistant CNV.
Methods:
This retrospective study analyzed OCTA and OCT biomarkers before and after treatment switch in patients with CNV that was resistant to prior anti-VEGF therapy. Quantitative vascular analysis of CNV lesions was performed using AngioTool 2.0 software. Anatomical response was evaluated by retinal fluid biomarkers, including central retinal thickness (CRT), intraretinal fluid (IRF), subretinal fluid (SRF), and pigment epithelial detachment (PED) volume using the RetinAI software.
Results:
Following the switch to Faricimab, OCTA analysis revealed reductions in vessel area (p = 0.011), vessel percentage area (p = 0.002), total vessel length (p = 0.011), and total number of junctions (p = 0.006). Lacunarity significantly increased (p = 0.009), indicating notable vascular remodeling. Moreover, AI-assisted imaging analysis showed that the CRT decreased by 9.94% (p = 0.0001), and PED volume decreased by 20.94% (p = 0.011). Total retinal fluid, including IRF and IRF, was reduced by 84.06% (p = 0.007), reflecting substantial anatomical improvement. Additionally, the mean injection interval increased by 3.19 ± 2.47 weeks, indicating enhanced disease stability and a reduced treatment burden.
Conclusion:
This study highlights the role of OCTA vascular analysis in assessing CNV treatment response. The significant vascular and AI-assisted anatomical improvements observed after switching to faricimab suggest its potential efficacy for treating resistant CNV cases. Given the scarcity of literature on OCTA vascular changes in this context, our findings provide novel insights into treatment response assessment. Further studies with larger cohorts are needed to validate these observations.
Insights
Faricimab shows promise for treatment-resistant choroidal neovascularization (CNV). Advanced OCTA and AI analysis revealed significant vascular remodeling and anatomical improvements, suggesting Faricimab
Area of Science:
- Ophthalmology
- Medical Imaging
- Vascular Biology
Background:
- Treatment-resistant choroidal neovascularization (CNV) poses a significant clinical challenge.
- Anti-VEGF therapies have limitations in managing refractory CNV.
- Faricimab, a dual inhibitor of VEGF-A and Ang-2, presents a novel therapeutic strategy.
Purpose of the Study:
- To evaluate the efficacy of Faricimab in treatment-resistant CNV.
- To utilize advanced OCTA and AI-assisted imaging for detailed response assessment.
- To provide novel insights into therapeutic response mechanisms in resistant CNV.
Main Methods:
- Retrospective analysis of OCTA and OCT biomarkers in patients with anti-VEGF resistant CNV.
- Quantitative vascular analysis of CNV lesions using AngioTool 2.0.
- AI-assisted evaluation of anatomical biomarkers (CRT, IRF, SRF, PED volume) using RetinAI software.
Main Results:
- Faricimab treatment led to significant reductions in CNV vascularity (vessel area, length, number of junctions) and increased lacunarity, indicating vascular remodeling.
- AI analysis demonstrated significant decreases in central retinal thickness (CRT) and pigment epithelial detachment (PED) volume.
- Substantial reduction in total retinal fluid (IRF and SRF) and an increased mean injection interval were observed, suggesting improved disease stability.
Conclusions:
- OCTA vascular analysis is valuable for assessing CNV treatment response.
- Faricimab demonstrates potential efficacy in resistant CNV, evidenced by significant vascular and anatomical improvements.
- Further research with larger cohorts is warranted to confirm these findings and their clinical implications.
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