Retina Society 2026: SOL-1 shows intravitreal axitinib hydrogel superior to aflibercept in wet AMD

Neovascular age-related macular degeneration (nAMD) remains a treatment-burden problem: real-world visual acuity gains erode as patients fall behind on frequent anti-VEGF injections. Intravitreal axitinib hydrogel (OTX-TKI/AXPAXLI; Ocular Therapeutix), which pairs a potent small-molecule tyrosine kinase inhibitor (TKI) with a bioresorbable hydrogel designed to release drug over 9 to 12 months, is being positioned as a durable maintenance therapy.

The Phase 3 SOL-1 trial (NCT06223958) is the first head-to-head superiority study in nAMD since ANCHOR and MARINA reported 20 years ago. In SOL-1, OTX-TKI met its primary endpoint of vision maintenance against aflibercept, giving retinal specialists their first randomized signal that a single intravitreal insert could hold vision and anatomy for the better part of a year.

Dilsher S. Dhoot, MD, FASRS, a vitreoretinal surgeon at California Retina Consultants (Retina Consultants of America) and a SOL-1 principal investigator, walks through the efficacy and safety data he presented, the trial's unusual FDA-aligned endpoint, the vitreous floater signal tied to hydrogel resorption, and what a true once-or-twice-yearly option could mean for undertreatment in clinical practice.