Prechoroidal cleft changes after intravitreal injections of Faricimab in treatment-naïve and nonresponders-to-aflibercept patients: A case series

Purpose To describe the clinical and optical coherence tomography (OCT) changes of prechoroidal cleft in treatment-na & iuml;ve and non-na & iuml;ve neovascular age-related macular degeneration (nAMD) treated with Faricimab intravitreal injections.Methods A case series (4 eyes from 4 patients).Results Cases 1 and 2 were diagnosed with treatment-na & iuml;ve nAMD. Case 1 showed minimal prechoroidal cleft persistence after treatment with visual acuity stabilization. Case 2 showed prechoroidal cleft resolution, followed by its recurrence with neovascular reactivation. Cases 3 and 4 had a history of nAMD unresponsive to Aflibercept therapy. In Case 3, prechoroidal cleft reappearance occurred simultaneously to neovascular reactivation. In Case 4 prechoroidal cleft resolved rapidly after switching to Faricimab, but this was complicated by the development of a retinal pigment epithelium (RPE) tear.Conclusion In this report, we highlight the importance of prechoroidal cleft as a negative prognostic OCT biomarker despite the increasingly proved efficacy of Faricimab. Pigment epithelium detachment height may correlate with the size of prechoroidal cleft and macular neovascularization (MNV) activity. Further studies are needed to better elucidate the prognostic significance of prechoroidal cleft after Faricimab therapy.