One-year results of the intravitreal administration of faricimab in patients with naïve type 3 macular neovascularization

To clarify the efficacy of the intravitreal injections of faricimab and the change in vascular morphology of retinal-retinal anastomosis (RRA) after treatment in patients with type 3 macular neovascularization (MNV). We retrospectively reviewed 20 consecutive eyes with treatment-naive type 3 MNV in 14 Japanese patients (mean age, 81.8 years) at different stages. All patients were treated with 3 or 4 consecutive monthly intravitreal injections of faricimab and then they were followed by a “treat and extend, then fix” regimen in the maintenance phase over a 12-month follow-up. The mean logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) levels improved significantly (P < 0.01) from 0.87 at baseline to 0.64 at 12 months. Optical coherence tomography angiography (OCTA) findings confirmed RRA in 16 (84.2%) of the 19 eyes, except for the eye with stage 1 at baseline, and 15 (93.8%) of the 16 eyes demonstrated the presence of vascular continuity at 12 months. No progression of retinal pigment epithelium (RPE) atrophy was observed in any of the 3 eyes with RPE atrophy at baseline, and newly developed RPE atrophy was seen in 4 (23.5%) of the 17 eyes without RPE atrophy at baseline. All 20 eyes had dry macula and showed no other complications at 12 months. Intravitreal faricimab injections significantly improved VA, achieved dry macula, and nearly normalized the vessels on the RRA in most patients with type 3 MNV during the 12-month study period.