EURETINA 2026: nAMD imaging biomarkers and real-world switch outcomes

Three e-posters presented at the 26th EURETINA Congress, held October 1–4, 2026, in Vienna, Austria,¹ address a common question in neovascular age-related macular degeneration (nAMD): how imaging findings and treatment choices should shape anti-VEGF care for the individual patient.

Two of the posters focus on optical coherence tomography (OCT) and OCT angiography biomarkers. In a prospective study from Brazil, Rezende et al report that baseline swept-source OCT and OCT angiography biomarkers were associated with the magnitude of anatomical and microvascular remodeling after aflibercept loading in treatment-naïve eyes.² In a retrospective cohort from Russia, Soshina et al found that the prognostic value of biomarkers such as subretinal hyperreflective material and subretinal fluid for treat-and-extend durability differed by macular neovascularization subtype.³

The third poster, a large real-world cohort of 739 eyes from Vienna by Lakits et al, found that eyes switched to faricimab or aflibercept 8 mg maintained stable visual acuity. Central subfield thickness decreased significantly after a switch to faricimab but changed little after a switch to aflibercept 8 mg.⁴

Taken together, the posters span the course of nAMD care, from treatment initiation to interval planning to switching agents, and support individualized, imaging-guided management. All 3 are single-center abstracts, 2 of them retrospective, and their findings should be considered hypothesis-generating.

Brief 1: Baseline SS-OCT and SS-OCTA biomarkers track anatomical response to aflibercept loading in treatment-naïve nAMD

Rezende M, Faria F, Beraldo D, Polido J, Belfort R, Cabral T (Brazil). EURETINA 2026 e-poster; category: Clinical Endpoints.

In treatment-naïve neovascular age-related macular degeneration (nAMD), baseline findings on swept-source OCT (SS-OCT) and swept-source OCT angiography (SS-OCTA) were associated with how much the retina, choroid, and neovascular complex changed after an aflibercept loading phase, according to a prospective study presented as an e-poster at EURETINA 2026.²

The investigators noted that SS-OCT and SS-OCTA allow high-resolution assessment of retinal and choroidal biomarkers in nAMD. However, prospective data on how these biomarkers relate to one another before and after therapy remain limited.

Study design

The single-center, prospective, interventional case series was conducted at a tertiary retina referral center in São Paulo, Brazil. It enrolled 21 eyes of 21 treatment-naïve patients with nAMD. Each eye received 3 monthly intravitreal aflibercept injections and was evaluated at baseline and at month 4, 1 month after the loading phase.

Biomarkers included best-corrected visual acuity (BCVA), central macular thickness (CMT), central choroidal thickness (CCT), macular neovascularization area (MNVA), vessel density, and the avascular areas of the superficial (AASP) and deep (AADP) capillary plexuses. Pretreatment and posttreatment values were compared, and correlations were assessed with Pearson or Spearman methods.

Results

Mean BCVA improved from 1.11 ± 0.47 logMAR at baseline to 0.56 ± 0.20 logMAR after loading (P < .001). CMT and CCT on SS-OCT, and MNVA, AASP, and AADP on SS-OCTA, were all significantly lower after treatment.²

The correlation analysis identified multiple statistically significant associations among structural, functional, and vascular measures:

• Baseline CMT correlated moderately with posttreatment CMT (r = 0.53; P = .013) and very strongly, in a negative direction, with CMT reduction (r = −0.95; P < .001).
• Baseline CCT correlated strongly with posttreatment CCT (r = 0.87; P = .002).
• BCVA correlated significantly with CMT at baseline and after treatment.
• Baseline MNVA correlated moderately and negatively with posttreatment CCT (r = −0.51; P = .019).
• AADP correlated with both baseline CMT and CMT reduction, and changes in AASP correlated with changes in CCT.

Clinical implications

The authors concluded that aflibercept loading produces coordinated functional, structural, and microvascular changes in treatment-naïve eyes. In their view, baseline SS-OCT and SS-OCTA biomarkers reflect initial disease burden and are also associated with the magnitude and direction of remodeling after treatment. They suggested that integrated multimodal biomarker assessment could improve prognostic stratification and support individualized management.²

Limitations

The sample was small and drawn from a single center, follow-up ended 1 month after the loading phase, and there was no comparator arm. With many biomarkers correlated across 21 eyes, some associations may reflect chance; the abstract does not report correction for multiple comparisons. Whether these baseline associations predict long-term visual outcomes or treatment burden during maintenance dosing was not assessed.

Brief 2: MNV subtype changes what OCT and OCTA biomarkers predict about treat-and-extend durability in nAMD

Soshina M, Mishustin V, Kormashova O, Korzun A (Russian Federation). EURETINA 2026 e-poster; category: Clinical Endpoints.

The same OCT or OCTA finding may carry different prognostic weight for treatment durability in neovascular age-related macular degeneration (nAMD) depending on the macular neovascularization (MNV) subtype, according to a retrospective cohort study presented as an e-poster at EURETINA 2026.³ The authors used their findings to build a phenotype-specific biomarker table intended to help clinicians set injection intervals.

The investigators noted that planning intervals in a treat-and-extend regimen remains challenging because clear, phenotype-specific reference points are limited. They aimed to identify biomarkers that could guide interval extension or shortening and reduce treatment-planning errors.

Study design

The retrospective observational cohort study was conducted at a specialized ophthalmology clinic between October 2024 and March 2026. It included treatment-naïve patients with nAMD who underwent standardized OCT and OCTA imaging and were followed under a treat-and-extend anti-VEGF protocol. The abstract does not name the anti-VEGF agent or agents used.

Eyes were classified as type 1 MNV, type 2 MNV, type 3 MNV/retinal angiomatous proliferation (RAP), or mixed MNV. Baseline OCT parameters included intraretinal fluid (IRF), subretinal fluid (SRF), pigment epithelial detachment, subretinal hyperreflective material (SHRM), external limiting membrane and ellipsoid zone integrity, and fibrosis. OCTA parameters included MNV area, vessel density, fractal dimension, and vascular network pattern. Treatment durability was defined as the longest interval achieved without recurrence over at least 12 months of follow-up, and multivariate analysis assessed associations among biomarkers, subtype, and interval.

Results

The cohort included 52 eyes of 35 patients with a mean (SD) age of 67.6 (8.97) years. Eighteen eyes (35%) had type 1 MNV, 10 had type 2, 8 had type 3/RAP, and 16 had mixed MNV. SRF was more common in type 1 MNV; IRF and SHRM were more common in type 2 and mixed MNV; and outer retinal disruption was more common in type 3/RAP.³

Key subtype-specific findings:

• SHRM was the strongest predictor of interval shortening in type 2 and mixed MNV, had a moderate effect in type 3/RAP, and had little impact in type 1 MNV when the outer retina was preserved.
• Type 1 MNV: Isolated SRF without IRF, SHRM, or outer retinal disruption did not signal a need to shorten the interval. Pronounced OCTA signs of chronic activity without those features also did not require shortening.
• Type 2 and mixed MNV: Shortening was associated with SHRM, IRF, fibrotic transformation, and high vascular complexity on OCTA.
• Type 3/RAP: Unfavorable indicators were IRF, outer retinal disruption, and small, vertically oriented vessels on OCTA.

Clinical implications

The authors concluded that OCT and OCTA biomarkers should be interpreted in light of MNV subtype, because identical imaging features may have different implications across phenotypes. They proposed their phenotype-specific biomarker table as an auxiliary tool for planning treat-and-extend regimens and selecting injection intervals.³

Limitations

The study was retrospective and single-center, and subgroups were small, with as few as 8 eyes in the type 3/RAP group. The abstract reports no effect sizes or P values from the multivariate analysis, does not specify the anti-VEGF agent, and does not include the biomarker table itself. The table would need external validation before it could inform routine interval decisions.

Brief 3: Real-world switch to faricimab or aflibercept 8 mg in nAMD keeps vision stable, with differing anatomical results

Lakits M, Bühl W, Kraiger J, Baratsits M, Weigert G, Sacu S (Austria). EURETINA 2026 e-poster; category: Clinical Endpoints.

In a large real-world cohort of eyes with neovascular age-related macular degeneration (nAMD), switching to faricimab or aflibercept 8 mg was associated with stable visual acuity, according to a retrospective study presented as an e-poster at EURETINA 2026.⁴ Central subfield thickness (CST) decreased significantly after a switch to faricimab but changed little after a switch to aflibercept 8 mg.

The investigators noted that faricimab and high-dose aflibercept were introduced to improve outcomes and reduce treatment burden in nAMD. However, randomized trials may not fully reflect routine practice, and comparative real-world data on outcomes after a therapy switch remain limited.

Study design

The retrospective study was conducted at the Department of Ophthalmology and Optometry, Medical University of Vienna, Austria. It included eyes with nAMD receiving intravitreal anti-VEGF therapy that were switched to faricimab or aflibercept 8 mg during routine clinical care.

Best-corrected visual acuity (BCVA) was measured with Snellen charts, recorded in decimal notation, and converted to logMAR. CST was measured with spectral-domain OCT. Pre-switch values were the last measurements before the first injection of the new agent, and post-switch values were the last available follow-up measurements. Mean changes in BCVA and CST were calculated for each group.

Results

The analysis included 739 eyes of 634 patients: 610 eyes switched to faricimab and 129 eyes switched to aflibercept 8 mg.

• Faricimab: Mean BCVA went from 0.3297 to 0.3382 logMAR (mean change, +0.0128; P > .05). Mean CST decreased from 298.1 μm to 285.8 μm (mean change, −11.8 μm; P = .01).
• Aflibercept 8 mg: Mean BCVA went from 0.4130 to 0.4411 logMAR (mean change, +0.0367; P > .05). Mean CST, 323.6 μm before the switch, changed little (mean change, +3.2 μm; P > .05).⁴

The authors described visual acuity as stable or slightly improved in both groups. Because higher logMAR values indicate poorer vision, however, the reported changes are more consistent with stable or slightly, nonsignificantly worse acuity than with improvement.

Clinical implications

The authors concluded that switching therapy was associated with stable functional outcomes in this cohort, with a significant anatomical response after a switch to faricimab but not after a switch to aflibercept 8 mg. They suggested the findings add real-world evidence on response patterns after a switch and may support treatment decisions for patients who need an alternative anti-VEGF agent.⁴

Limitations

The study was retrospective and single-center, and patients were not randomized to either agent. The aflibercept 8 mg group was smaller and started with worse BCVA and thicker CST than the faricimab group, so the results should not be read as a head-to-head comparison. The abstract does not report follow-up duration, prior agents, reasons for switching, number of injections, or treatment intervals. As a result, it cannot address treatment burden, which was a stated rationale for both agents.

Linking the three: imaging-guided nAMD care from initiation to switching

These 3 EURETINA 2026 e-posters follow the arc of anti-VEGF management in nAMD: starting treatment, setting intervals, and changing agents. Each suggests that a single finding or treatment decision is best interpreted in the context of the individual eye.

Starting treatment: baseline imaging as a gauge of response

Rezende et al show that baseline SS-OCT and SS-OCTA measures reflect disease burden and are associated with the extent of anatomical and microvascular remodeling after aflibercept loading.² Their work addresses the induction phase, when clinicians first see how an eye responds.

Maintaining treatment: phenotype-aware interval decisions

Soshina et al take up the maintenance phase. They argue that the same biomarker, such as SRF or SHRM, cannot be read uniformly, because its significance for treat-and-extend intervals depends on MNV subtype.³ Read together with Rezende et al, the studies suggest a stepwise approach: use baseline multimodal imaging to gauge burden and expected response, then interpret ongoing findings by phenotype when setting intervals.

Changing treatment: response after a switch

Lakits et al address eyes that need a new agent. In their cohort, visual acuity held steady after a switch to faricimab or aflibercept 8 mg, while CST decreased significantly only after the switch to faricimab.⁴

Their analysis relied on a single anatomical measure, CST, which the other 2 posters suggest may not capture the full picture. Phenotype-specific markers such as SHRM, IRF, and outer retinal integrity could help explain which eyes respond anatomically to a given agent, a question the switch data cannot answer on their own.

Shared caveats

All 3 are single-center e-poster abstracts, not peer-reviewed full reports. Two are retrospective, and none randomized patients or compared its proposed approach against usual care. Sample sizes range from 21 to 739 eyes, and none reports injection counts. The posters are best read as hypothesis-generating signals that support multimodal, individualized nAMD care and warrant validation in prospective studies.

References

1. 26th Euretina Congress: general information. Euretina. Accessed September 30, 2026. https://euretina.org/vienna-2026/general/

2. Rezende M, Faria F, Beraldo D, Polido J, Belfort R, Cabral T. Correlation analysis of swept-source OCT and OCT angiography biomarkers in treatment-naïve patients with neovascular age-related macular degeneration treated with aflibercept: a prospective study. E-poster presented at: 26th Euretina Congress; October 1-4, 2026; Vienna, Austria.

3. Soshina M, Mishustin V, Kormashova O, Korzun A. Same fluid, different phenotype: MNV subtype-specific OCT/OCTA biomarkers as predictors of treatment durability in neovascular AMD. E-poster presented at: 26th Euretina Congress; October 1-4, 2026; Vienna, Austria.

4. Lakits M, Bühl W, Kraiger J, Baratsits M, Weigert G, Sacu S. Real-world functional and anatomical outcomes after treatment switch to faricimab or aflibercept 8 mg in neovascular age-related macular degeneration: a large cohort study. E-poster presented at: 26th Euretina Congress; October 1-4, 2026; Vienna, Austria.