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Related Experiment Video

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Experimental Autoimmune Uveitis: An Intraocular Inflammatory Mouse Model
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Inflammation and Occlusive Retinal Vasculitis Post Faricimab.

Will Bruening1, Sean Kim1, Steven Yeh1

  • 1Truhlsen Eye Center, Department of Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha.

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Mild intraocular inflammation (IOI) after faricimab may precede occlusive retinal vasculitis (ORV). Repeated exposure can lead to irreversible vision loss, highlighting the need for caution with this biologic.

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Area of Science:

  • Ophthalmology
  • Immunology

Background:

  • Faricimab, a novel vascular endothelial growth factor and angiopoietin-2 inhibitor, is approved for neovascular age-related macular degeneration (nAMD) and diabetic macular edema.
  • Clinical trials demonstrate faricimab's safety and efficacy, but rare adverse events may not be fully characterized.

Purpose of the Study:

  • To report cases of irreversible vision loss following mild intraocular inflammation (IOI) after faricimab treatment.
  • To investigate the potential link between faricimab exposure, IOI, and subsequent occlusive retinal vasculitis (ORV).

Main Methods:

  • Retrospective case series of 3 patients treated at a single academic tertiary referral center.
  • Analysis of clinical symptoms, signs, and outcomes in patients who developed ORV after initial faricimab exposure and subsequent rechallenge.

Main Results:

  • Three eyes developed occlusive retinal vasculitis (ORV) after initial mild IOI and subsequent faricimab rechallenge.
  • Profound, irreversible vision loss occurred in affected eyes despite aggressive treatment.
  • One eye without IOI did not experience adverse events upon rechallenge.

Conclusions:

  • Caution is advised when re-administering faricimab after even mild IOI.
  • Repeated exposure may elicit an immunological memory response, leading to ORV and vision loss.