Ophthalmology and Therapy · Published 2026-07-01 · DOI 10.1007/s40123-026-01405-1
Mohamed Zakaria Sherif, Kelvin Y. C. Teo, Timothy Y. Y. Lai, Hiok Hong Chan, Beau J. Fenner, Won Ki Lee, Chui Ming Gemmy Cheung
Abstract Introduction Polypoidal choroidal vasculopathy (PCV) is a major subtype of neovascular age-related macular degeneration (nAMD), particularly prevalent in Asian and pigmented populations. While anti-vascular endothelial growth factor (anti-VEGF) therapy has improved outcomes, limitations in durability and incomplete polypoidal lesion regression remain. This review provides an updated synthesis of emerging evidence on newer anti-VEGF agents in PCV management. Methods This narrative review synthesizes recent evidence in PCV management, integrating data from clinical trials and emerging real-world studies, with a focus on newer anti-VEGF agents including faricimab (Vabysmo, Roche/Genentech)and aflibercept 8 mg (Eylea HD, Regeneron). Results Faricimab, a bispecific antibody targeting VEGFA and angiopoietin-2 (Ang-2), demonstrated non-inferior efficacy compared with aflibercept 2 mg administered every 8 weeks in the TENAYA/LUCERNE trials, with over 70% of patients achieving dosing intervals of ≥ 12 weeks. The SALWEEN study further evaluated faricimab in 135 patients with PCV, reporting robust visual gains (+ 8.9 letters), 61% polypoidal lesion regression, and over 80% of patients achieving ≥ 12-week dosing intervals at 48 weeks. Aflibercept 8 mg, evaluated in the PULSAR trial, demonstrated comparable safety and efficacy with improved anatomical drying and extended dosing intervals (12–16 weeks) compared with aflibercept 2 mg. In a subgroup analysis of 139 eyes with indocyanine green angiography (ICGA)-confirmed PCV, outcomes were consistent with the overall study population, with similar visual and anatomical improvements but reduced injection burden. More than 80% of eyes achieved dosing intervals of ≥ 12 weeks at 2 years. Conclusions Faricimab and aflibercept 8 mg represent important advances in PCV management, offering more durable treatment options and reducing treatment burden. However, important gaps remain, including limited real-world data for aflibercept 8 mg, absence of head-to-head PCV-specific trials, and uncertainty regarding long-term recurrence and lesion inactivation. These findings support a shift toward increasingly individualized and durable treatment strategies in PCV.
Abstract from DOAJ. Public domain (CC0 1.0).
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Sherif, M., Teo, K., Lai, T., et al. (2026). Advances in Polypoidal Choroidal Vasculopathy (PCV) Management: Emerging Evidence for Faricimab and Aflibercept 8 mg. Ophthalmology and Therapy. https://doi.org/10.1007/s40123-026-01405-1