Vitritis following intravitreal faricimab: a retrospective monocentric analysis.

IF 2.4 3区 医学 Q2 OPHTHALMOLOGY
Alexandre Bourdin, Salomon Yves Cohen, Sylvia Nghiem-Buffet, Jerome Smadja, Michel Paques, Franck Fajnkuchen, Sarah Mrejen
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引用次数: 0

Abstract

Purpose: Intravitreal injections of anti-VEGF agents are considered as safe, with a very low rate of intraocular inflammations (IOI). Faricimab is a novel intravitreal bispecific antibody targeting both VEGF-A and angiopoietin-Tie2 independently. Despite a safe profile in randomized clinical trials, several real-life studies have reported cases of IOI. The aim of this monocentric study was to report the incidence and clinical course of intraocular inflammation following intravitreal faricimab injections.

Methods: A retrospective analysis was performed in our tertiary care center, based on the observation of cases between December 1, 2023 and April 30, 2024. The incidence of intraocular inflammation occurring following faricimab injections compared to other anti-VEGF agents and dexamethasone implants was assessed over the study period.

Results: Intraocular inflammation was observed in 11 eyes of seven patients, and presented as isolated, painless anterior uveitis with retrocorneal precipitates in three cases and vitritis associated with anterior uveitis in eight cases. The pattern of vitritis appeared distinctive, characterized by dense, grayish vitreous bands observed mainly in the peripheral fundus. The inflammatory phase persisted for 2-10 weeks, and regressed with steroid treatment. The overall incidence of IOI with faricimab was 0.87% (11 out of 1,271 injections), with vitritis specifically observed in 0.63% of cases (8 out of 1,271 injections). In contrast, of the 3,728 injections of other anti-VEGF agents administered (including 1,765 injections of aflibercept, 1,952 injections of ranibizumab) and 43 injections of dexamethasone implants, no cases of intraocular inflammation were reported.

Conclusions: Our initial experience with faricimab indicates a potentially higher risk of intraocular inflammation, including a distinctive pattern of vitritis, compared to aflibercept and ranibizumab. The benefit/risk ratio should be carefully assessed, particularly in patients with monocular vision or who require simultaneous bilateral injections.

玻璃体法利西单抗后玻璃体炎:回顾性单中心分析。
目的:抗血管内皮生长因子药物的玻璃体内注射被认为是安全的,眼内炎症(IOI)发生率非常低。法立替单抗是一种新型的玻璃体内双特异性抗体,可独立靶向血管内皮生长因子-A和血管生成素-Tie2。尽管在随机临床试验中安全性很高,但仍有几项实际研究报告了 IOI 病例。这项单中心研究旨在报告玻璃体内注射法尼单抗后眼内炎的发生率和临床过程:方法:我们在三级医疗中心对 2023 年 12 月 1 日至 2024 年 4 月 30 日期间的病例进行了回顾性分析。与其他抗血管内皮生长因子药物和地塞米松植入物相比,评估了研究期间法尼单抗注射后眼内炎症的发生率:7名患者的11只眼睛出现眼内炎,其中3例表现为孤立的无痛性前葡萄膜炎,伴有角膜后沉淀物,8例表现为前葡萄膜炎伴有玻璃体炎。玻璃体炎的形态特征明显,主要是在眼底周围观察到致密的灰白色玻璃体带。炎症期持续 2-10 周,类固醇治疗后可消退。使用法尼单抗的 IOI 总发生率为 0.87%(1,271 次注射中有 11 次),其中 0.63% 的病例(1,271 次注射中有 8 次)观察到玻璃体炎。相比之下,在注射的 3,728 次其他抗 VEGF 药物(包括 1,765 次注射阿弗利百普、1,952 次注射雷尼珠单抗)和 43 次注射地塞米松植入剂中,没有发现眼内炎症病例:我们使用法尼单抗的初步经验表明,与阿夫利韦齐和雷尼珠单抗相比,法尼单抗引起眼内炎症(包括独特模式的玻璃体炎)的风险可能更高。应仔细评估其收益/风险比,尤其是单眼视力或需要同时进行双侧注射的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.40
自引率
7.40%
发文量
398
审稿时长
3 months
期刊介绍: Graefe''s Archive for Clinical and Experimental Ophthalmology is a distinguished international journal that presents original clinical reports and clini-cally relevant experimental studies. Founded in 1854 by Albrecht von Graefe to serve as a source of useful clinical information and a stimulus for discussion, the journal has published articles by leading ophthalmologists and vision research scientists for more than a century. With peer review by an international Editorial Board and prompt English-language publication, Graefe''s Archive provides rapid dissemination of clinical and clinically related experimental information.
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