Abstract
Purpose :
To report the functional and anatomic outcomes of Faricimab in patients with neovascular age-related macular degeneration (nAMD) recalcitrant to other anti-VEGF agents.
Methods :
Retrospective interventional study of patients with refractory nAMD initially treated with intravitreal bevacizumab, ranibizumab or aflibercept that were switched to monthly Faricimab injections. Central subfield thickness (CST), intraretinal fluid (IRF) or subretinal fluid (SRF) height and visual acuities were compared.
Results :
13 eyes (8 right eye and 5 left eye) of 11 patients were followed for 10.4 ± 6.9 and 40.3 ± 28.7 months after receiving bevacizumab and aflibercept respectively until switching to faricimab. Follow-up time for patients receiving a mean of 3.7 ± 1.3 faricimab injection was 3.4 ± 1.2 months. Overall median CST was reduced by 18µm (IQR 6µm to 48.5µm, p=0.001) from 342µm (IQR 314.5µm to 435.5µm) to 318µm (IQR 281µm to 339µm) along with reduction of 89µm (IQR 32µm to 144µm, p=0.03) IRF/SRF height from 97µm (IQR 74µm to 255.5µm) to 40µm (IQR 0 to 163.8µm). After one injection of Faricimab (n=13), the median CST and IRF/SRF height reduced 5µm (IQR 1µm to 29.5µm, p=0.064) and 15µm (IQR 7µm to 111µm, p=0.2), respectively. After three consecutive injections (n=10), the CST and IRF/SRF height showed significant reduction of 21.5 µm (IQR 7.25µm to 56.8µm, p=0.004) from 344µm (IQR 321µm to 425.8µm) to 322.5µm (IQR 269.5µm to 337.5µm) and 89µm (IQR 70.5µm to 155µm, p=0.03) from 104µm (IQR 83.5µm to 294.5µm) to 18.5µm (IQR 0 to 163.8µm), respectively. The intraretinal fluid size was decreased with cessation of leakage on fluorescein angiography. Visual acuity remained stable after switching to faricimab treatment (0.59 ± 0.45 logMAR vs 0.58 ± 0.45 logMAR, p=1). No ocular or systemic side effects were observed.
Conclusions :
Faricimab is an effective treatment for nAMD resistent to other anti-VEGF agents in terms of anatomical improvement and vision preservation.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.