Evaluating Retinal Drying, Durability and IOP Management with Second-Generation Anti-VEGF Therapies in Retinal Vascular Diseases

This segment examines real-world comparisons between faricimab and aflibercept 8 mg in terms of retinal drying, durability, and intraocular pressure (IOP) management. Clinicians note that both agents extend treatment intervals modestly—often by about one additional week compared with standard 2 mg aflibercept—but not to the 12–16 weeks seen in clinical trial messaging. Aflibercept 8 mg appears to provide slightly greater drying and durability, though treatment flexibility remains constrained by current labeling. Discussion turns to concerns about potential IOP spikes and long-term optic nerve effects due to the higher injection volume. The panel highlights data showing that cumulative injection frequency, rather than dose volume, drives long-term IOP risk. They also reference findings on prefilled syringe variability and advocate for improved precision in dosing to ensure safety and consistency. Overall, both agents demonstrate strong efficacy and reassuring safety, with durability gains enhancing patient convenience and clinic efficiency.