Sterile Intraocular Inflammation in Patients Receiving Both Faricimab and High-Dose Aflibercept in Consecutive Order

Purpose: To describe 3 cases of intraocular inflammation (IOI) in patients who received faricimab and high-dose aflibercept in consecutive order. Methods: Retrospective case review. Results: Three patients, 2 with neovascular age-related macular degeneration (nAMD) and 1 with central retinal vein occlusion (CRVO), transitioned from 2 mg aflibercept to either faricimab (in cases 1 and 2) or high-dose aflibercept (in case 3) due to persistent disease activity. In all cases, contemporary medication provided minimal effect. Subsequently, patients in cases 1 and 2 were switched to high-dose aflibercept at their next visit, and the patient in case 3 was switched to faricimab. On follow-up, the disease worsened in all 3 cases. Each patient returned to their previous drug. Shortly after, each patient developed an episode of IOI. Conclusions: Patients receiving different high-dose or longer-acting agents in short order may be at risk for developing antidrug antibodies and IOI.