Faricimab in neovascular AMD: first report of real-world outcomes in an independent retina clinic

PurposeAssess short-term real-world outcomes in neovascular aged-related macular degeneration (nAMD) treated with novel faricimab.MethodsRetrospective case series of nine patients with nAMD (11 eyes) treated with faricimab between May and November 2022. Treatment-naive patients and non-naive patients underwent logMAR best corrected visual acuity (BCVA), optical coherence tomography (OCT) DRI OCT-1 Triton (Topcon Corp, Tokyo, Japan), ultra-widefield (UWF) and fundus autofluorescence (FAF) (California Optomap, Optos plc, Dunfermline, Scotland, UK). Previous treatment intervals, number of intravitreal injections, sub/intra retinal fluid (SRF/IRF), central retinal thickness (CRT) and presence/changes in pigment epithelial detachments (PEDs) were recorded.ResultsMean baseline BCVA and CRT values of patients who switched from other agents were 0.612 +/- 0.75 logMAR and 256.16 +/- 12.98 mu m respectively, with a mean 36-day previous treatment interval. The median number of other previous anti-VEGF intravitreal injections was 8. Mean BCVA at one month significantly improved to 0.387 +/- 0.54 logMAR, as well as CRT values which decreased to 245.43 +/- 15.34 mu m. In the 3 naive patients, mean baseline BVCA and CRT values were 0.33 +/- 0.29 and 874.67 +/- 510.86 mu m, respectively. At one month follow-up, mean BCVA improved to 0.30 +/- 0.29 logMAR and mean CRT was 536.04 +/- 36.15 mu m. Overall, a significant improvement in BCVA of 0.21 +/- 41 logMAR and 238.44 +/- 114.9 mu m was achieved at one month after the first faricimab intravitreal injection. In addition, a complete resolution of SRF was observed in 6 out of 8 eyes (75%) and of IRF in 2 out of 3 eyes (66.67%), respectively. Drusenoid PED morphology changes were observed in all patients and no drug-related adverse events were observed.ConclusionReal-world outcomes showed improvement in BCVA and anatomic parameters at an early timepoint, demonstrating the efficacy and durability of faricimab in nAMD patients. Larger numbers of patients and longer follow-up are needed to determine whether the loading dose is required in all, what percentage of patients experience an improvement, and whether improvement it is maintained.