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

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 the baseline OCT characteristic analysis, 29 patients (35 eyes) in the MNV analysis, and 18 patients (21 eyes) in the PED analysis. Significant decreases in PED parameters were observed, including PED volume (mean decrease of 0.0592 mm³ (-19.66%; p = 0.0164), sample standard deviation (ssd) = 0.114 mm³), mean height (mean decrease of 0.00871 mm (-19.16%; p = 0.0003), ssd = 0.0143 mm), and maximum height (mean decrease of 0.0242 mm (-15.28%; p = 0.002), ssd = 0.0359). Significant decreases in MNV metrics were also observed, including area (mean decrease of 0.252 mm² (-9.06%; p = 0.0054), ssd = 0.519 mm²), and vessel area density (mean decrease of 6.51% absolute (-8.23%; p = 0.0004), ssd = 0.0943% absolute). BCVA (logMAR) remained stable between baseline and 3 months (0.25-0.23; p = 0.34). Notably, there were no statistically significant changes in the percentage of eyes with intraretinal fluid (IRF) or subretinal fluid (SRF) between baseline and 3 months (all p > 0.05).

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.