gms | German Medical Science

Background: To assess short-term functional and anatomical outcomes of intravitreal faricimab (IVF) for previously treated refractory neovascular age-related macular degeneration (nAMD) in real-world setting.

Methods: Retrospective analysis of 15 eyes treated with 4x IVI of faricimab 6 mg/0.05 mL and followed for 4 weeks after last IVI. All patients were switched to IVF after treatment with at least two other anti-vascular endothelial growth factors (VEGF). All eyes received 4x IVI monthly as an upload phase.

Main outcome measures: best corrected visual acuity (BCVA), central macular thickness (CMT), and retinal fluid distribution.

Results: 15 eyes of 15 patients with nAMD (67% males) with a mean age of 79±6 years were included. The number of previous anti-VEGF IVIs/eye was 34±20 before switching to IVF. BCVA (logMAR) did not change significantly from 0.7±0.27 to 0.62±0.3 (p=0.48). CMT (µm) decreased significantly from 426±65 to 373±66 (p=0.03). The number of eyes with subretinal fluid (SRF) decreased significantly from 10 (67%) to 4 (16%) (p=0.02). There were no significant changes regarding the distribution of intraretinal fluid or pigment epithelial detachment (p>0.05). A complete retinal and subretinal fluid resolution was achieved in 2 eyes (13%). No adverse events were noticed.

Conclusion: In the short term, IVF resulted in significant decrease in CMT, as well as SRF rate, and thus appears to be an effective treatment alternative for the management of therapy-refractory nAMD. However, a significant increase in visual acuity was not observed.