Michael W. Stewart, MD

A panelist discusses how a 76-year-old patient with neovascular age-related macular degeneration (nAMD) initially stable on bevacizumab developed recurrent subretinal fluid requiring a switch to aflibercept 2 mg, but after experiencing sterile inflammatory responses to both aflibercept 2 and 8 mg doses, was successfully treated with faricimab every 6 weeks, demonstrating the value of having structurally different anti-VEGF agents to minimize cross-antigenicity when immune responses occur.

A panelist discusses how a 62-year-old patient with age-related macular degeneration (AMD) who could never be extended beyond 4-week intervals with aflibercept 2 mg achieved complete macular drying and improved vision with aflibercept 8 mg, though temporary vision loss from acute IOP elevation required dose modification to 0.06 mL (6.86 mg) to maintain efficacy while avoiding pressure-related complications.

A panelist discusses how an 83-year-old patient with diabetic macular edema (DME) who showed suboptimal response to standard anti-VEGF therapies, including aflibercept 2 mg and faricimab, ultimately achieved significant visual and anatomic improvement when switched to high-dose aflibercept (8 mg), demonstrating the enhanced efficacy of the higher molar dose formulation.