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

Figures & data

Figure 1 Treatment protocol. Intervention schedule for patients with age-related macular degeneration treated with faricimab. We administered three, monthly injections of 6 mg faricimab, and evaluated the efficacy two months after the third injection (month 4). Clinical data were collected at baseline and month 4. ×, Faricimab injection (6 mg); 〇, clinical data collection; □, efficacy endpoint.

Table 1 Baseline Demographic and Clinical Characteristics of Patients with Neovascular Age-Related Macular Degeneration

	Total Eyes (n = 23)
Age (y)	75.4±7.6
Sex (male/female)	13/10
Axial length (mm)	23.46±0.90
Subtype (tAMD/PCV/RAP)	12/10/1
LogMAR visual acuity	0.29±0.30 (20/39)
Greatest linear dimension (μm)	3439.1±1901.2
Fluid
SRF (±)	23/0
IRF (±)	5/18
SRH (±)	9/14
CMT (μm)	324.5±193.2
Subfoveal CT (μm)	287.8±103.1
Maximum PED height (μm)	244.1±182.9
Maximum SHRM height (μm)	159.3±127.0
Vitreoretinal adhesion (±)	6/17
Intact foveal EZ (±)	11/12
Intact foveal ELM (±)	20/3

Abbreviations: tAMD, typical age-related macular degeneration; PCV, polypoidal choroidal vasculopathy; RAP, retinal angiomatous proliferation; SRF, subretinal fluid; IRF, intraretinal fluid; SRH, subretinal hemorrhage; PED, pigment epithelial detachment; SHRM, subretinal hyper-reflective material; EZ, ellipsoid zone; ELM, external limiting membrane; logMAR, logarithm of minimum angle resolution; CMT, central macular thickness; CT, choroidal thickness.

Figure 2 Visual and anatomic outcome of age-related macular degeneration (AMD) eyes treated with faricimab. (A and B) Changes in the logarithm of minimum angle resolution (logMAR) visual acuity (VA) in total eyes (A), and typical age-related macular degeneration (tAMD) and polypoidal choroidal vasculopathy (PCV) eyes (B). (C–F) Changes in central retinal thickness (CRT) (C), subfoveal choroidal thickness (SFCT) (D), maximum pigment epithelial detachments (PED) height (E), and maximum subretinal hyperreflective material (SHRM) height (F) in total eyes. *P < 0.05, **P < 0.005, ***P < 0.001 compared between two groups (A and C–F), and between baseline and month 4 (B).

Table 2 Comparison of Baseline Characteristics Between Neovascular AMD Patients with and without Pachychoroid Phenotypse

	Pachychoroid Phenotypes (+) N = 11	Pachychoroid Phenotypes (-) N = 12	P value
Age (y)	72.9±8.2	77.8±6.2	0.140
Sex (male/female)	7/4	6/6	0.680
Axial length (mm)	23.66±0.93	23.28±0.83	0.334
Subtype (tAMD/PCV/RAP)	5/6/0	7/4/1	1.000
LogMAR visual acuity	0.23±0.18 (20/34)	0.34±0.37 (20/44)	0.423
Greatest linear dimension (μm)	2916.6±1371.2	3918.2±2173.6	0.225
CVH (%)	9 (81.2)	1 (8.3)	0.0006
Fluid
SRF (±)	11/0	12/0	1.000
IRF (±)	2/9	3/9	1.000
SRH (±)	4/7	5/7	1.000
CMT (μm)	271.2±97.5	373.3±240.5	0.223
Subfoveal CT (μm)	333.1±100.8	246.3±86.3	0.046
Maximum PED height (μm)	186.4±127.8	297.1±208.1	0.161
Maximum SHRM height (μm)	141.6±68.9	175.6±161.3	0.543
Vitreoretinal adhesion (±)	2/9	4/8	0.640
Intact foveal EZ (±)	7/4	4/8	0.220
Intact foveal ELM (±)	11/0	9/3	0.217

Abbreviations: tAMD, typical age-related macular degeneration; PCV, polypoidal choroidal vasculopathy; RAP, retinal angiomatous proliferation; CVH, choroidal vascular hyperpermeability; SRF, subretinal fluid; IRF, intraretinal fluid; SRH, subretinal hemorrhage; PED, pigment epithelial detachment; SHRM, subretinal hyper-reflective material; EZ, ellipsoid zone; ELM, external limiting membrane; logMAR, logarithm of minimum angle resolution; CRT, central retinal thickness; CT, choroidal thickness.

Figure 3 Comparison of visual and anatomic outcome between age-related macular degeneration (AMD) with and without pachychoroid phenotypes. Changes in the logarithm of minimum angle resolution (logMAR) visual acuity (VA) (A), subfoveal choroidal thickness (SFCT) (B), central retinal thickness (CRT) (C), maximum pigment epithelial detachments (PED) height (D), and maximum subretinal hyperreflective material (SHRM) height (E) in age-related macular degeneration (AMD) with and without pachychoroid phenotypes. *P < 0.05, **P < 0.005, ***P < 0.001 compared between baseline and month 4 (A–E), and ^†P < 0.05 compared between eyes with and without pachychoroid phenotypes (C).

Table 3 Predictive Factors of Visual Acuity at Month 4 in Patients with Faricimab

	Pearson Correlation Coefficient	P value
CRT	0.443	0.039
Maximum SHRM height	0.512	0.015
	Spearman Rank Correlation Coefficient	P value
IRF +	0.551	0.008
SRH +	0.471	0.027
Intact foveal ELM	−0.587	0.004

Abbreviations: IRF, intraretinal fluid; SRH, subretinal hemorrhage; SHRM, subretinal hyper-reflective material; ELM, external limiting membrane; CRT, central macular thickness.

Table 4 Results of Multiple Linear Regression After Step-Wise Selection in Patients Treated with Faricimab

Variable	B	95% CI	β	P value
(Constant)	0.710	0.468 to 0.952	NA	7.0x10^−6
ELM	−0.670	−0.912 to −0.429	−0.708	1.4x10^−5
IRF	0.242	0.027 to 0.457	0.288	0.029

Abbreviations: IRF, intraretinal fluid; ELM, external limiting membrane.

Figure 4 Comparison of visual and anatomic outcome between age-related macular degeneration (AMD) with and without dry macula at month 4. (A) Prevalence of dry macula, SRF, and IRF at baseline and month 4. (B and C) Changes in central retinal thickness (CRT) (B), and logarithm of minimum angle resolution (logMAR) visual acuity (VA) (C) in age-related macular degeneration (AMD) with and without dry macula at month 4. **P < 0.005, ***P < 0.001 compared between baseline and month 4 (B and C).