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Background and Importance Age-related macular degeneration (AMD) is a leading cause of irreversible central vision loss. The exudative form, responsible for 90% of cases of severe vision loss, benefits from anti-angiogenic therapy, mainly aflibercept and bevacizumab, with faricimab as a second-line option. Personalised treatments and optimised vial compounding by pharmaceutical services is essential to maximise effectiveness and reduce treatment burden.Aim and Objectives To evaluate the use of anti-angiogenic agents in exudative AMD: identifying the most used drugs, administration patterns, and the rationale for therapeutic switches.Material and Methods Retrospective observational study analysing NOA-Digital data from January to September 2025. The dataset included 2490 scheduled treatments in 417 patients. After the loading dose phase, therapeutic switches were further assessed in 47 patients. Data analysis was performed with Python.Results Among 2490 intravitreal injections, 1063 were aflibercept 40 mg/mL, 308 bevacizumab 25 mg/mL, and 805 faricimab 120 mg/mL. Laterality was balanced (52% right vs 48% left eyes). Aflibercept was administered in 188 patients, with a mean of five injections per patient and a dosing interval of 7 weeks. Faricimab was used in 131 patients, 6 weeks average interval. Bevacizumab was less frequent (63 patients). A total of 147 therapeutic switches occurred, mainly from aflibercept to faricimab (n=45; 31%). After loading dose, dosing intervals extended from 5.5 to 7.4 weeks on average, with two patients reaching 12 weeks. Switches were mainly due to optical coherence tomography (OCT) fluid (n=39; 83%) and to extend intervals (n=7; 15%). Visual acuity improved in 25 patients (53,2%), remained stable in 11 (23,4%), and worsened in 11 (23,4%). Three uveitis cases with aflibercept were recorded: two resolved with anti-inflammatories, one progressed to retinal detachment requiring treatment discontinuation.Conclusion and Relevance Aflibercept continues to be the first-line treatment, showing strong efficacy and safety. Switches highlight the value of individualised regimens. Faricimab is a promising option, enabling longer dosing intervals. OCT fluid remains the main criteria for therapeutic change. Hospital pharmacist validation and Pharmacy and Therapeutics Committee approval ensure safety, equity, and optimal resource allocation.Conflict of Interest No conflict of interest