Intravitreal faricimab as an adjuvant in the management of tubercular uveitis

• Published in: Retinal cases & brief reports
• Main Authors: Alcibahy, Yasmine, Julian, Karina, Bonilla, M Fernanda, Mohamed, Ali, Amrani, Sarah, Agarwal, Aniruddha
• Format: Journal Article
• Language: English
• Published: United States 19.12.2023
• ISSN: 1937-1578
• DOI: 10.1097/ICB.0000000000001542

To report the use of intravitreal faricimab used as an adjunct in the management of intraocular tuberculosis (IOTB) in a patient with occlusive retinal vasculitis (ORV) and choroiditis. A case report. A 27-year-old Asian male presented with bilateral choroiditis and ORV complicated by retinal neovascularization and vitreous hemorrhage in one eye. The patient had a positive tuberculin skin test, indeterminate interferon-gamma release assay, and Ghon's focus on chest radiography. With a diagnosis of IOTB, the patient was treated with anti-tubercular therapy. Due to the significant vitreous hemorrhage, he underwent pars plana vitrectomy in one eye. The patient received bilateral faricimab. Within a week of the injection, he had a near-complete resolution of the extensive choroidal and retinal vascular inflammation. Intravitreal faricimab, given its angiopoietin-2 (ang2) inhibition and anti-vascular endothelial growth factor action, maybe a helpful adjunct in IOTB. Whether ang2 inhibition provides any additional benefit needs further evaluation in extensive studies.