Intraocular Inflammation Following Intravitreal Faricimab Injection in Neovascular Age-Related Macular Degeneration

We herein report intraocular inflammation (IOI) following intravitreal (IVT) faricimab injection in three patients. A 73-year-old male, a 68-year-old female, and an 82-year-old female, all diagnosed with neovascular age-related macular degeneration (AMD), had received multiple anti-vascular endothelial growth factor (anti-VEGF) injections for the same. They were injected with IVT faricimab due to non-response to other agents. Following IVT faricimab, two patients presented with mild vitritis (grade 2) within three days post-injection, and one patient presented with anterior uveitis on day 1. No associated retinal vasculitis or occlusion was present. All patients responded well to topical steroid therapy. Notably, the 68-year-old lady had a history of IOI (mild vitritis) following a single IVT brolucizumab in the past. The other two patients had not received IVT brolucizumab earlier. IOI after IVT faricimab has been reported a few times previously. One must be aware of the spectrum of presentation (vitritis, anterior uveitis, panuveitis, vascular occlusion, vasculitis) and be vigilant to provide timely management, especially in sight-threatening cases. A history of IOI following previous brolucizumab injection needs to be evaluated further for possible immunological mechanisms at play.