Short-Term Outcomes of 3 Monthly intravitreal Faricimab On Different Subtypes of Neovascular Age-Related Macular Degeneration

• Published in: Clinical ophthalmology (Auckland, N.Z.) N.Z.), 2024-01, Vol.18, p.507-516
• Main Authors: Tanaka, Asako, Hata, Masayuki, Tsuchikawa, Memiri, Ueda-Arakawa, Naoko Ueda-Arakawa, Tamura, Hiroshi, Miyata, Manabu, Takahashi, Ayako, Kido, Ai, Muraoka, Yuki, Miyake, Masahiro, Ooto, Sotaro, Tsujikawa, Akitaka
• Format: Article
• Language: English
• Subjects: anti-vascular endothelial growth factor; anti-vegf; Care and treatment; central retinal thickness; Comparative analysis; crt; elm; external limiting membrane; faricimab; intraretinal fluid; irf; Macular degeneration; macular neovascularization; Medical research; Medicine, Experimental; mnv; neovascular age-related macular degeneration; nvamd; pachychoroid neovasculopathy; pcv; Pharmaceutical industry; Physiological aspects; pnv; polypoidal choroidal vasculopathy; rap; retinal angiomatous proliferation; Vascular endothelial growth factor
• ISSN: 1177-5467; 1177-5483; 1177-5483
• DOI: 10.2147/OPTH.S448507

To evaluate the efficacy and safety of faricimab injections for treatment-naïve neovascular age-related macular degeneration (nvAMD) patients, including subtypes and pachychoroid phenotypes, and identify predictive factors for visual outcomes. nvAMD patients were prospectively recruited, receiving three monthly faricimab (6 mg) injections. Best-corrected visual acuity (BCVA) two months after the last injection (month 4) was compared between subtypes, and between pachychoroid neovasculopathy (PNV) and non-PNV eyes. Regression analysis determined factors influencing month 4 BCVA. The study involved 23 patients (12 typical AMD [tAMD], 10 polypoidal choroidal vasculopathy [PCV], 1 retinal angiomatous proliferation [RAP]). Eleven exhibited PNV phenotype. Significant BCVA ( = 4.9 × 10 ) and central retinal thickness (CRT) ( = 1.3 × 10 ) improvements were observed post-faricimab treatment. The therapy demonstrated favourable results for both tAMD and PCV eyes, and non-PNV and PNV eyes. Faricimab achieved dry macula in 77.3% of eyes, with subretinal fluid resolution in most cases, although intraretinal fluid (IRF) often persisted. Multivariable analysis identified external limiting membrane (ELM) presence and IRF as BCVA contributors at month 4. Faricimab demonstrated significant effectiveness and safety in treatment-naïve nvAMD patients, particularly for PCV and PNV eyes. ELM presence and IRF is predictive of visual outcomes.