Recurrent sterile endophthalmitis following intravitreal Faricimab: A case report

Despite its low risk profile and high efficacy described in several studies, there appears to be an increasing number of reports describing sterile inflammatory reactions following intravitreal administration of Faricimab. Purpose of this case report is to highlight the occurrence of recurrent sterile endophthalmitis following repeated intravitreal Faricimab administration, emphasizing the need for awareness and careful monitoring of this adverse reaction.

We present the case of an 83-year-old caucasian woman, who was treated with intravitreal Faricimab for neovascular age-related macular degeneration (nAMD) in her left eye (OS). Shortly after the first administration, she experienced progressive, painless visual deterioration, along with a pronounced inflammatory reaction in the anterior and posterior segments, including granulomatous keratic precipitates. Based on these findings, the diagnosis of endophthalmitis was made. Following hospital admission, immediate treatment led to resolution of the condition and recovery of visual acuity.On the first day after the second administration of Faricimab, the patient again experienced painless visual deterioration accompanied by a severe inflammatory reaction OS. Immediate treatment once more resulted in resolution of the condition and recovery of visual acuity. In both instances, no microbial growth was detected in fungal cultures or aerobic and anaerobic cultures from aqueous humor and vitreous samples.

We present a case of recurrent endophthalmitis in the same patient following two intravitreal administrations of Faricimab. Considering the clinical presentation and course, as well as the microbiological findings, a sterile inflammatory reaction is likely in both instances.