Intravitreal Faricimab in Patients with Chronic Wet Age-Related Macular Degeneration: A Case Series

Abstract

Purpose : Neovascular age-related macular degeneration (nvAMD) is a leading cause of vision loss for older adults. The purpose of our study is to evaluate clinical outcomes of Faricimab in the treatment of nvAMD.

Methods : This was a retrospective case series of patients who received at least three intravitreal Faricimab injections for refractory nvAMD between November 2022 -June 2023. Inclusion criteria were patients with nvAMD, who had previously received intravitreal treatments of Bevacizumab, Aflibercept or Ranibizumab and did not have any change in the OCT findings. Outcome measurements included visual acuity (VA) as Log MAR, central subfield thickness, Pigment Epithelial Detachment (PED) width (microns) and height (microns), choroidal thickness (microns), and subretinal fluid (SRF) and intraretinal fluid (IRF) surface areas (mm²) as measured by optical coherence tomography (OCT). Values were measured monthly from 0 to 6 months.

Results : 50 patients (22 Male, 28 Female) with mean age of 83.94±8.67 were included in the study. Initial Log MAR (visual acuity) was 0.51±0.39 and at month 3 was 0.55 ± 0.4(P value=0.271) and at month 6 was 0.59 ± 0.47(P value=0.663). Central subfield thickness decreased significantly at month 1 (350.35 ± 202.81, P=0.023 and month 2 (333.65 ± 96.34, p=0.014) compared to initial value of 361.82 ± 205.21. Initial Subfoveal choroidal thickness was 173±74.23, decreased significantly at month 1 (160.05 ± 75.91, P=0.002) and month 3 (142.8 ± 73.13, P=0.018).SRF decreased at months 2 and 4(0.02 ± 0.03 mm², P=0.01 and 0.02 ± 0.02, P=0.007), respectively, but IRF did not change significantly.

Conclusions : After switching to Faricimab, treatment-resistant subjects had a significant reduction in subretinal fluid and subfoveal choroidal thickness with no significant improvement in VA. These results are limited by a small sample size. More longitudinal analysis is needed to evaluate real world outcomes of Faricimab for recalcitrant wet nvAMD.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.