Analysis of quantitative OCT and SS-OCTA metrics three months after initiation of intravitreal faricimab for treatment-recalcitrant neovascular AMD

Abstract

Abstract Purpose To utilize optical coherence tomography (OCT) and SS-OCT angiography (SS-OCTA) for quantifying morphological changes seen in eyes with recalcitrant neovascular age-related macular degeneration (nAMD) transitioned to intravitreal faricimab injections during the manufacturer’s recommended induction phase of treatment. Methods Fifty-four treatment-recalcitrant patients (60 eyes) were recruited. OCT and SS-OCTA images were obtained at 0 and 3 months. Best corrected visual acuity (BCVA), OCT, pigment epithelial detachment (PED), and macular neovascularization (MNV) parameters were analyzed at baseline and 3 months. Results Thirty-two patients (38 eyes) were included in baseline OCT characteristic analysis, 29 patients (35 eyes) in MNV analysis, and 18 patients (21 eyes) in PED analysis. Significant decreases in PED parameters were observed, including PED volume (mean = -19.66%, 95% CI [-36.77, -2.40], p = 0.0114), mean height (mean = -19.16%, 95% CI [-33.50, -4.81], p = 0.0114), and maximum height (mean = -15.28%, 95% CI [-25.59, -4.97], p = 0.0057). Significant decreases in MNV metrics were also observed, including area (mean = -9.06%, 95% CI [-15.45, -2.66], p = 0.0069) and vessel density (mean = -8.23%, 95% CI [-12.46, -4.01], p = 0.0004). BCVA remained stable between baseline and 3 months. Conclusions In recalcitrant nAMD patients who were transitioned to faricimab, patients maintained their vision while significant improvements in OCT PED and SS-OCTA MNV parameters were seen during the induction phase.