Preliminary Efficacy of Intravitreal Faricimab for Type 1 Retinopathy of Prematurity : A Pilot Case Series

This study aimed to first present the preliminary efficacy, reactivation rate, and safety of intravitreal faricimab (IVF) in patients with type 1 ROP. This was a single-center, consecutive pilot case series. Infants with type 1 ROP treated with IVF monotherapy (3 mg/0.025 mL) between December 2024 and May 2025 were included. The primary outcomes were treatment response, the reactivation rate, and the interval to reactivation. Secondary outcomes included the absence of ocular complications and significant systemic adverse events. A total of 10 eyes from 5 infants were included, all of whom completed at least 6 months of follow-up. The mean gestational age (GA) was 27.17 ± 0.60 weeks (range, 26.29–28.00 weeks), and the mean birth weight (BW) was 1132 ± 344 g (range, 910–1760 g). All eyes (100%) demonstrated complete regression of ROP after initial IVF, with continued peripheral vascularization. Two eyes (20%) from one patient experienced reactivation at 15 weeks after treatment and underwent repeat IVF injection. At the last follow-up, all eyes achieved complete vascularization or reached zone III, with no unfavorable anatomical outcomes, ocular complications, or systemic adverse events. IVF monotherapy demonstrated favorable preliminary efficacy and safety in type 1 ROP. Larger prospective studies with longer follow-up are needed to confirm reactivation rates and durability. • First report on intravitreal faricimab monotherapy for type 1 ROP • All treated eyes showed regression with continued vascularization • Only 20% of eyes experienced reactivation after initial treatment • No ocular complications or systemic adverse events observed