Analysis of the aqueous humor before and after the administration of faricimab in patients with nAMD

Abstract

This study aimed to evaluate the changes in cytokine levels in the aqueous humor and factors of treatment resistance following intravitreal faricimab injection in treatment-naïve patients with neovascular age-related macular degeneration. A total of 32 eyes were analyzed before and after a single faricimab injection. Although the best-corrected visual acuity (BCVA) showed no significant improvement, the mean central retinal thickness decreased significantly by 73.7% (P < 0.01), and more than 90% of the eyes showed improvement in exudative changes 1 month after faricimab injection. Moreover, the aqueous humor concentrations of vascular endothelial growth factor (VEGF)-A, angiopoietin (Ang)-2, and placental growth factor considerably decreased 1 month after faricimab injection. Multivariate analyses adjusted for age, sex, BCVA, central choroidal thickness, and aqueous humor cytokines revealed that higher Ang-2 levels in the aqueous humor at baseline were associated with better treatment response to faricimab injection. These findings suggest that the dual inhibition of VEGF-A and Ang-2 by faricimab is effective in reducing exudative changes and that Ang-2 may serve as a potential biomarker for predicting faricimab treatment response.

Keywords: Analysis in aqueous humor; Angiopoietin-2; Anti-vascular endothelial growth factor; Faricimab; Neovascular age-related macular degeneration.

Fig. 1

Changes in the mean best-corrected visual acuity (BCVA), central retinal thickness (CRT), and central choroidal thickness (CCT) at 1 month after intravitreal faricimab treatment. * p < 0.05, Wilcoxon signed-rank test. ** p < 0.01, Wilcoxon signed-rank test.

Fig. 2

Exudative changes in 32 eyes treated with faricimab injection. The graph shows the number of eyes in which the fluid shown on the Y-axis was fully resolved (fully resolved), decreased (decrease), unchanged (no change), or increased (increase) compared with the optical coherence tomography findings at baseline. IRF, intraretinal fluid; SRF, subretinal fluid; sub-RPE fluid, subretinal pigment epithelium fluid.

Fig. 3

Changes in the aqueous humor concentrations (pg/mL) of the cytokines. Data are presented as mean ± standard deviation unless otherwise indicated. ** P < 0.01, Wilcoxon signed-rank test. (a) Ang-2, angiopoietin-2; (b) PlGF, placental growth factor; (c) VEGF-A, vascular endothelial growth factor-A.