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The following is a summary of “Severe intraocular inflammation after intravitreal injection of faricimab: a single-site case series of six patients,” published in the August 2024 issue of Ophthalmology by Ghezala et al.

Researchers conducted a retrospective study to describe the patient characteristics and clinical course of severe intraocular inflammation (IOI) following intravitreal injection (IVT) of faricimab. 

They reviewed a case series from Dijon University Hospital, France, where 263 patients received faricimab IVT between January 9, 2024, and May 7, 2024.

The results showed that over 4 months, 1,659 eyes from 1,338 patients received anti-vascular endothelial growth factor (anti-VEGF) IVTs for a total of 3,510 IVTs, including 343 eyes from 263 patients who received faricimab IVTs for a total of 971 IVTs. Out of these, 6 eyes with neovascular age-related macular degeneration developed severe unilateral IOI after faricimab IVT (1/162 injections, 0.62%). Symptoms included severe anterior and intermediate uveitis, mild to moderate pain, and moderate vitritis associated with granulomatous keratic precipitates in two eyes and non-occlusive vasculitis in 1 eye. Diagnosis of infectious endophthalmitis was unlikely due to the clinical presentation of sterile vitreous culture and rapid improvement with treatment. An average visual loss of +0.2 logMAR was experienced by 4 patients, and 2 had positive antinuclear antibodies, including one with a history of cutaneous lupus. 

Investigators concluded that severe IOI occurred in 0.6% of intravitreal faricimab injections over 4 months. More real-world data is needed to understand better the frequency and nature of this rare inflammatory reaction.

Source: ajo.com/article/S0002-9394(24)00361-1/fulltext