Week in review: Faricimab durability, mysterious floaters, frosty eyes

A weekly roundup of ophthalmic news from around the web.

Faricimab has shown “strong” durability in a pair of phase 3 studies for diabetic macular edema (DME), announced Genentech. Patients receiving treatment every 8 weeks or at personalized dosing intervals of up to 16 weeks showed noninferior visual gains compared with aflibercept dosed every 8 weeks. The drug also achieved something unprecedented for a phase 3 DME study: More than half of the faricimab-personalized-dosing arms achieved an extended treatment interval of 16 weeks at year 1. No new safety signals arose. Additional phase 3 studies are underway to assess the drug’s long-term safety and tolerability for DME, and its potential for wet AMD. Genentech

A novel ointment AZR-MD-001 appears to improve contact lens discomfort as soon as 1 month after starting treatment. According to Azura Ophthalmics, the drug’s active ingredient selenium disulfide targets hyperkeratinization, the root of meibomian gland dysfunction. Topline results from a 26-patient phase 2 study revealed that twice-weekly application of AZR-MD-001 to the lower lid significantly improved meibum gland secretion score by day 14, and showed statistical superiority over vehicle after 1.5 months or more of treatment. Azura is planning an additional study with the help of an international panel of experts. Azura Ophthalmics

Artificial intelligence algorithms detect diabetic eye disease inconsistently, according to a new report published Jan. 5 in Diabetes Care. Investigators tested 7 platforms from 5 companies—Eyenuk, Retina-AI Health, Airdoc, Retmarker and OphtAI—and found that the algorithms don’t perform as well as they claim. In real-world settings, sensitivities varied widely between 51% to 86%. Most algorithms performed no better than human teleretinal screeners, and 1 had lower sensitivity for proliferative DR. “It’s alarming that some of these algorithms are not performing consistently since they are being used somewhere in the world," said lead researcher Aaron Lee, MD. University of Washington School of Medicine

Mysterious floaters plagued this 43-year-old patient’s left eye (image above) for an entire year. His visual acuity was 20/20 in both eyes and there were no anterior segment abnormalities. Fundus examination uncovered a single, spherical, translucent, free-floating pigmented cyst in the vitreous cavity that was almost 4 disc diameters; ultrasonography showed no internal hyperechogenicity. Where did it come from, you ask? Ultrasound biomicroscopy revealed a well-defined, temporal, clear ciliary body cyst 0.9 by 0.7 mm in size, suggesting it may have been the origin of the pigmented vitreous cyst. Ophthalmology Retina

A new case study hints that a rare ocular complication could be a sign of systemic inflammation after allogenic hematopoietic stem cell transplantation. Published in The Lancet Haematology, the patient—who received the transplant for acute-type adult T-cell leukemia-lymphoma—was initially fine but suddenly developed bilateral blurred vision 54 months after the procedure. Ocular examination revealed frosted branch angiitis, which physicians suspected was caused by an immune response to the transplant. Although corticosteroids cleared the angiitis by 6 months, the patient developed a neck skin rash and dry eye after discontinuing treatment—implying the immune response that caused the initial ocular symptoms may have been systemic. Tokyo Medical and Dental University, The Lancet Haematology