Clearside Biomedical (CLSD) 10-K 12 Mar 24 2023 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2023	Mar. 05, 2024	Jun. 30, 2023
Cover [Abstract]
Entity Registrant Name	Clearside Biomedical, Inc.
Amendment Flag	false
Document Period End Date	Dec. 31, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Trading Symbol	CLSD
Document Type	10-K
Entity Central Index Key	0001539029
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		74,721,139
Entity Public Float			$ 64,000,000
Entity Interactive Data Current	Yes
Title of 12(b) Security	Common Stock, par value $0.001 per share
Security Exchange Name	NASDAQ
Entity File Number	001-37783
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	45-2437375
Entity Address, Address Line One	900 North Point Parkway
Entity Address, Address Line Two	Suite 200
Entity Address, City or Town	Alpharetta
Entity Address, State or Province	GA
Entity Address, Postal Zip Code	30005
City Area Code	678
Local Phone Number	270-3631
Document Annual Report	true
Document Transition Report	false
Documents Incorporated by Reference	Portions of the Company’s definitive proxy statement, to be filed (no later than 120 days after December 31, 2023) pursuant to Regulation 14A under the Securities Exchange Act of 1934, for its 2024 Annual Meeting of Stockholders are incorporated by reference into Part III of the Form 10-K.
Auditor Name	Ernst & Young LLP
Auditor Location	Atlanta, Georgia
Auditor Firm ID	42

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 28,920	$ 48,258
Accounts receivable	170	0
Prepaid expenses	722	704
Other current assets	311	439
Total current assets	30,123	49,401
Property and equipment, net	2,996	755
Operating lease right-of-use asset	869	1,117
Other assets	30	30
Total assets	34,018	51,303
Current liabilities:
Accounts payable (includes $331 to a related party as of December 31, 2023)	2,205	1,050
Accrued liabilities (includes $215 to a related party as of December 31, 2023)	4,169	4,179
Current portion of operating lease liabilities	364	349
Deferred revenue	75	205
Total current liabilities	6,813	5,783
Liability related to the sales of future royalties, net	41,988	33,977
Operating lease liabilities	649	936
Other non-current liabilities	480	0
Total liabilities	49,930	40,696
Commitments and contingencies
Stockholders' (deficit) equity:
Preferred stock, $0.001 par value; 10,000,000 shares authorized and no shares issued at December 31, 2023 and 2022	0	0
Common stock, $0.001 par value; 200,000,000 shares authorized at December 31, 2023 and 2022, respectively; 62,850,841 and 59,722,930 shares issued and outstanding at December 31, 2023 and 2022, respectively	63	61
Additional paid-in capital	304,948	298,984
Accumulated deficit	(320,923)	(288,438)
Total stockholders' (deficit) equity	(15,912)	10,607
Total liabilities and stockholders' (deficit) equity	$ 34,018	$ 51,303

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Accounts payable current related party	$ 331
Accrued liabilities to a related party	$ 215
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares issued	0	0
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	200,000,000	200,000,000
Common stock, shares, issued	62,850,841	60,639,827
Common stock, shares outstanding	62,850,841	60,639,827

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
License and other revenue (includes $5,050 from a related party for the year ended December 31, 2023)	$ 8,226	$ 1,327	$ 29,575
Type of Revenue [Extensible List]	License [Member]	License [Member]	License [Member]
Operating expenses:
Cost of goods sold	$ 355	$ 204	$ 0
Research and development (includes $1,109 to a related party for the year ended December 31, 2023)	20,846	19,630	18,537
General and administrative	11,869	11,770	11,665
Total operating expenses	33,070	31,604	30,202
Loss from operations	(24,844)	(30,277)	(627)
Other income	1,719	669	1,003
Non-cash interest expense on liability related to the sales of future royalties	(9,360)	(3,339)	0
Net (loss) income	$ (32,485)	$ (32,947)	$ 376
Net (loss) income per share of common stock - basic	$ (0.53)	$ (0.55)	$ 0.01
Net (loss) income per share of common stock - diluted	$ (0.53)	$ (0.55)	$ 0.01
Weighted average shares outstanding - basic	61,806,959	60,204,862	58,491,986
Weighted average shares outstanding - diluted	61,806,959	60,204,862	59,906,602

Consolidated Statements of Op_2

Consolidated Statements of Operations (Parenthetical) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($)
Income Statement [Abstract]
License and other revenue from Related Party	$ 5,050
Research and development to Related Party	$ 1,109

Statement of Stockholders' Equi

Statement of Stockholders' Equity (Deflicit) - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In-Capital	Accumulated Deficit
Beginning balance at Dec. 31, 2020	$ 8,763	$ 52	$ 264,578	$ (255,867)
Beginning balance, shares at Dec. 31, 2020		51,860,941
Issuance of common shares under at-the-market sales agreement	12,205	$ 3	12,202
Issuance of common shares under at-the-market sales agreement, shares		2,891,419
Issuance of common shares under a direct registered offering	11,078	$ 4	11,074
Issuance of common shares under a direct registered offering, shares		4,209,050
Issuance of common shares under employee stock purchase plan	111		111
Issuance of common shares under employee stock purchase plan, shares		65,481
Exercise of stock options	388	$ 1	387
Exercise of stock options, shares		280,771
Vesting and settlement of restricted stock units, shares		415,268
Share-based compensation expense	5,054		5,054
Net income (loss)	376			376
Ending balance at Dec. 31, 2021	37,975	$ 60	293,406	(255,491)
Ending balance, shares at Dec. 31, 2021		59,722,930
Issuance of common shares under at-the-market sales agreement	566	$ 1	565
Issuance of common shares under at-the-market sales agreement, shares		425,460
Issuance of common shares under employee stock purchase plan	112		112
Issuance of common shares under employee stock purchase plan, shares		66,919
Exercise of stock options	17	$ 0	17
Exercise of stock options, shares		49,187
Vesting and settlement of restricted stock units, shares		375,331
Share-based compensation expense	4,884		4,884
Net income (loss)	(32,947)			(32,947)
Ending balance at Dec. 31, 2022	10,607	$ 61	298,984	(288,438)
Ending balance, shares at Dec. 31, 2022		60,639,827
Issuance of common shares under at-the-market sales agreement	1,666	$ 2	1,664
Issuance of common shares under at-the-market sales agreement, shares		1,589,699
Issuance of common shares under employee stock purchase plan	65		65
Issuance of common shares under employee stock purchase plan, shares		68,109
Exercise of stock options	33	$ 0	33
Exercise of stock options, shares		81,816
Vesting and settlement of restricted stock units, shares		471,390
Share-based compensation expense	4,202		4,202
Net income (loss)	(32,485)			(32,485)
Ending balance at Dec. 31, 2023	$ (15,912)	$ 63	$ 304,948	$ (320,923)
Ending balance, shares at Dec. 31, 2023		62,850,841

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating activities
Net (loss) income	$ (32,485)	$ (32,947)	$ 376
Adjustments to reconcile net (loss) income to net cash used inoperating activities:
Non-cash interest expense on liability related to the sales of future royalties, net of issuance costs accretion	9,361	3,339	0
Depreciation	67	145	178
Share-based compensation expense	4,202	4,884	5,054
Gain on termination of operating lease	0	(55)	0
Loss on disposal of fixed assets	0	33	0
Gain on extinguishment of debt	0	0	(998)
Changes in operating assets and liabilities:
Accounts receivable, prepaid expenses and other current assets	(220)	10,420	(10,869)
Other assets and liabilities	456	(83)	(155)
Accounts payable and accrued liabilities (includes $82 to a related party for the year ended December 31, 2023)	614	694	681
Deferred revenue	(130)	205	(5,000)
Net cash used in operating activities	(18,135)	(13,365)	(10,733)
Investing activities
Acquisition of property and equipment	(1,777)	(246)	0
Net cash used in investing activities	(1,777)	(246)	0
Financing activities
Proceeds from royalty purchase and sale agreement, net of $1,862 of issuance costs	0	30,638	0
Payments on royalty purchase and sale agreement	(1,350)	0	0
Proceeds from at-the-market sales agreement, net of issuance costs	1,666	566	12,205
Proceeds from registered direct offering, net of issuance costs	0	0	11,078
Proceeds from shares issued under employee stock purchase plan	65	112	111
Proceeds from exercise of stock options	33	17	388
Net cash provided by financing activities	414	31,333	23,782
Net (decrease) increase in cash, cash equivalents and restricted cash	(19,498)	17,722	13,049
Cash, cash equivalents and restricted cash, beginning of period	48,418	30,696	17,647
Cash, cash equivalents and restricted cash, end of period	28,920	48,418	30,696
Supplemental disclosure
Purchase of property and equipment in accounts payable and accrued liabilities	531	282	0
Forgiveness of PPP Loan and accrued interest	0	0	998
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	28,920	48,258	30,436
Restricted cash ($160 and $100 as of December 31, 2022 and 2021, respectively, is recorded in other current assets)	0	160	260
Cash, cash equivalents and restricted cash at end of period	$ 28,920	$ 48,418	$ 30,696

Statements of Cash Flows (Paren

Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Cash Flows [Abstract]
Accounts Payable And Accrued Liabilities To A Related party	$ 82
Restricted cash in other current assets		$ 160	$ 100
Restricted Cash, Statement of Financial Position [Extensible Enumeration]	Other current assets
Proceeds from royalty purchase and sale agreement	$ 1,862

The Company

The Company	12 Months Ended
	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
The Company	1. The Company Clearside Biomedical, Inc. (the “Company”) is a biopharmaceutical company focused on revolutionizing the delivery of therapies to the back of the eye through the suprachoroidal space (SCS). Incorporated in the State of Delaware on May 26, 2011 , the Company has its corporate headquarters in Alpharetta, Georgia. The Company’s activities since inception have primarily consisted of developing product and technology rights, raising capital and performing research and development activities. The Company is subject to a number of risks and uncertainties similar to those of other life science companies at a similar stage of development, including, among others, the need to obtain adequate additional financing, successful development efforts including regulatory approval of products, compliance with government regulations, successful commercialization of potential products, protection of proprietary technology and dependence on key individuals. Liquidity The Company had cash and cash equivalents of $ 28.9 million as of December 31, 2023. Historically, the Company has funded its operations primarily through the sale of common stock and convertible preferred stock, the issuance of long-term debt, and license agreements. On October 25, 2021, the Company announced that the U.S. Food and Drug Administration (the "FDA") approved XIPERE ® (triamcinolone acetonide injectable suspension) for the treatment of macular edema associated with uveitis, a form of eye inflammation. In January 2022, the Company received $ 10.0 million from Bausch + Lomb, a division of Bausch Health Companies, Inc. ("Bausch"), upon completion of pre-launch activities for XIPERE pursuant to the license agreement granting Bausch an exclusive license to develop and commercialize XIPERE in the United States and Canada. Bausch launched XIPERE in the United States in the first quarter of 2022. On February 6, 2024, the Company entered into a securities purchase agreement with institutional investors and an existing stockholder, pursuant to which the Company issued and sold, in a registered direct offering (the “Registered Direct Offering”): (i) an aggregate of 11,111,111 shares (the “Shares”) of its common stock; and (ii) warrants to purchase up to 11,111,111 shares of common stock (the “Warrants”). The combined purchase price of each Share and accompanying Warrant was $ 1.35 . The exercise price for the Warrants is $ 1.62 per share. The Warrants will be exercisable from August 9, 2024 and will expire on August 9, 2029 . The net proceeds to the Company from the Registered Direct Offering were approximately $ 13.9 million. On January 31, 2024 (the “Amendment Effective Date”), the Company entered into a fourth amendment to the license agreement (as amended, the “Emory License Agreement”) with Emory University and Georgia Tech Research Corporation (collectively, the “Licensor”) pursuant to which the parties agreed to reduce the Sublicense Percentage (as defined in the Emory License Agreement) from a low double digit percentage to a high single digit percentage that the Company will pay the Licensor applicable to any fees or payments paid to the Company by any Sublicensee (as defined in the Emory License Agreement) of the Licensed Patents and/or Licensed Technology (each as defined in the Emory License Agreement), on or after July 1, 2023, excluding (i) amounts paid to the Company by a Sublicensee to reimburse the Company for certain research and development costs pursuant to a written agreement between the Company and such Sublicensee, (ii) the value of intellectual property transferred or granted to the Company if necessary or helpful to the development or commercialization of Licensed Products (as defined in the Emory License Agreement) and (iii) amounts paid for shares of the Company’s stock. The payment to Licensor of any such Sublicense Percentage is due within 30 days of receipt by the Company of a qualifying payment from a Sublicensee, provided however, with respect to any qualifying payments received by the Company from a Sublicensee after July 1, 2023 but prior to January 1, 2025, the payment to Licensor of any such Sublicensee Percentage is due to Licensor by March 31, 2025. The parties also agreed to a revised annual license maintenance fee due each year (the “Maintenance Fee”) starting in 2023 through 2028, as follows: $ 250,000 for 2023 through 2025, $ 350,000 for 2026, $ 400,000 for 2027 and $ 500,000 for 2028. The Company paid the Maintenance Fee for 2023 in February 2024. The remaining annual Maintenance Fee payments are due on October 1st of each year. On December 22, 2023, Clearside Biomedical, Inc., through its wholly owned subsidiary Royalty Sub, entered into a letter agreement (the “Letter Agreement”) with HCR and HCR Clearside SPV, LLC (as assignee of HCR Collateral Management, LLC) (“Agent”) amending that certain Purchase and Sale Agreement, dated as of August 8, 2022, by and among Royalty Sub, HCR and Agent. Pursuant to the terms of the Letter Agreement, Royalty Sub and Agent mutually agreed that Royalty Sub waived any and all rights to the $ 12.5 million milestone payment which was deposited in an escrow account (“First Milestone Payment") in connection with the closing of the transactions contemplated by the Purchase and Sale Agreement and agreed to the release of the First Milestone Payment to Agent. The First Milestone Payment was to be released to Royalty Sub upon attainment of a pre-specified XIPERE sales milestone if such milestone was achieved by March 31, 2024 (“First Milestone Event”) or, at Agent’s option, in the event the First Milestone Event was not achieved. On November 1, 2023, the Company , entered into a license agreement (the “BioCryst License Agreement”) with BioCryst Pharmaceuticals, Inc. (“BioCryst”) pursuant to which the Company granted BioCryst an exclusive, worldwide and sublicensable license to the Company’s SCS Microinjector for the delivery of BioCryst’s proprietary plasma kallikrein inhibitor known as avoralstat for the treatment and prevention of diabetic macular edema (“DME”). The Company received an upfront license fee payment of $ 5.0 million in connection with signing of the BioCryst License Agreement. In addition, the Company is eligible to receive up to an additional $ 30.0 million in clinical and regulatory milestone payments, and up to a total of $ 47.5 million in a series of post-approval sales-based milestone payments based on the achievement of annual global net product sales milestones up to $ 2.0 billion. Further, during the royalty term, BioCryst has also agreed to pay the Company tiered mid-single digit royalties on annual global net product sales, with the highest royalty rate applied to sales over $ 1.5 billion, subject to reductions in specified circumstances. The Company’s rights to these royalties and milestone payments have been sold pursuant to the terms and conditions of the Purchase and Sale Agreement described above in in Note 5 to the consolidated financial statements. In May 2023, the Company terminated its at-the-market sales agreement with Cowen and Company, LLC (the "ATM Agreement"). The Company sold 515,959 shares of its common stock for net proceeds of $ 0.7 million under its ATM Agreement with Cowen and Company, LLC during the six months ended June 30, 2023, prior to the termination of the ATM Agreement. During the year ended December 31, 2022, the Company so ld 425,460 shares of its common stock for net proceeds of $ 0.6 million under its ATM Agreement. During the year ended December 31, 2021, the Company sold 2.9 million shares of its common stock for net proceeds of $ 12.2 million under its ATM Agreement. In May 2023, the Company entered into a Controlled Equity Offering SM Sales Agreement (the "Sales Agreement") with Cantor Fitzgerald & Co. ("Cantor") under which the Company may offer and sell, from time to time at its sole discretion, shares of its common stock, having an aggregate offering price of up to $ 50.0 million through Cantor as its sales agent. During the year ended December 31, 2023, the Company sold 1,073,740 shares of its common stock for net proceeds of $ 1.1 million under the Sales Agreement. Subsequent to December 31, 2023, the Company sold an additional 339,912 shares of its common stock pursuant to the Sales Agreement for net proceeds of $ 0.5 million. On August 8, 2022, the Company entered into a Purchase and Sale Agreement (the "Purchase and Sale Agreement") pursuant to which it sold its rights to receive royalty and milestone payments due to the Company from XIPERE and certain SCS Microinjector license agreements subject to a cap which may be increased under certain circumstances. The Company received a payment of $ 32.1 million in September 2022, representing the $ 32.5 million to which the Company was entitled, net of certain of HCR's transaction-related expenses which the Company agreed to reimburse. There were additional issuance costs of $ 1.5 million related to the Purchase and Sale Agreement resulting in net proceeds of $ 30.6 million. On January 6, 2021, the Company entered into a securities purchase agreement with certain institutional purchasers that purchased 4.2 million shares of its common stock in a registered direct offering at a price of $ 2.851 per share. The Company raised net proceeds of $ 11.1 million after deducting offering expenses. In August 2021, the Company entered into an amendment to the Arctic Vision License Agreement (as defined in Note 10 - License and Other Agreements) to expand the territories covered by the license to include India and the ASEAN Countries (Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam). In September 2021, the Company entered into a second amendment to the Arctic Vision License Agreement to expand the territories covered by the license to include Australia and New Zealand. The Company received an aggregate of $ 3.0 million in consideration for the expansion of the licensed territory. Based on its current plans and forecasted expenses, the Company expects that its cash and cash equivalents as of the filing date, March 12, 2024 will enable it to fund its planned operating expenses and capital expenditure requirements into the third quarter of 2025. The Company has based this estimate on assumptions that may prove to be wrong, and it could exhaust its capital resources sooner than expected. Until the Company can generate sufficient revenue, the Company will need to finance future cash needs through public or private equity offerings, license agreements, debt financings or restructurings, collaborations, strategic alliances and marketing or distribution arrangements.

Significant Accounting Policies

Significant Accounting Policies	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Significant Accounting Policies	2. Significant Accounting Policies Basis of Presentation and Principles of Consolidation The Company's consolidated financial statements include the results of the financial operations of Clearside Biomedical, Inc. and its wholly-owned subsidiary, Clearside Royalty LLC. a Delaware limited liability company, which was formed for the purposes of the transactions contemplated by the Purchase and Sale Agreement described in Note 5. All intercompany balances and transactions have been eliminated. The Company’s financial statements have been prepared in conformity with accounting principles generally accepted in the United States of America (“U.S. GAAP”). Use of Estimates The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and reported amounts of income and expenses during the reporting periods. Significant items subject to such estimates and assumptions include the estimate of the total amount of future royalty revenue and milestone payments to be generated over the life of the Purchase and Sale Agreement, revenue recognition, the accounting for useful lives to calculate depreciation and amortization, clinical trial expense accruals, share-based compensation expense and income tax valuation allowance. Actual results could differ from these estimates. Revenue Recognition The Company recognizes revenue from its contracts with customers under Financial Accounting Standards Board Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers . The Company’s primary revenue arrangements are license agreements which typically include upfront payments, regulatory and commercial milestone payments and royalties based on future product sales. The arrangements may also include payments for the Company’s SCS Microinjector devices as well as payments for assistance and oversight of the customer’s use of the Company’s technology. In determining the amount of revenue to be recognized under these agreements, the Company performs the following steps: (i) identifies the promised goods and services to be transferred in the contract, (ii) identifies the performance obligations, (iii) determines the transaction price, (iv) allocates the transaction price to the performance obligations and (v) recognizes revenue as the performance obligations are satisfied. The Company receives payments from its customers based on billing schedules established in each contract. Up-front and other payments may require deferral of revenue recognition to a future period until the Company performs its obligations under the arrangement. Amounts are recorded as accounts receivable when the Company’s right to consideration is unconditional. The Company does not assess whether a contract has a significant financing component if the expectation at contract inception is such that the period between payment by the customer and the transfer of the promised goods or services to the customer will be one year or less. In the year ended December 31, 2023, 2022, and 2021, the Company recognized $ 8.2 million, $ 1.3 million, and $ 29.6 million of revenue associated with its license agreements, respectively. License revenue for the year ended December 31, 2023 was primarily for a non-refundable $ 5.0 million upfront license fee payment from BioCryst and $ 1.4 million of milestone payments from Aura Biosciences, Inc. The $ 5.0 million non-refundable upfront payment was recognized upon transfer of control of the license to BioCryst. The $ 1.4 million in milestone payments from Aura were recognized upon satisfaction of the related performance obligations. Remaining revenues for the year ended December 31, 2023 were generated by providing training materials and clinical trial products to the Company's licensees. License revenue for the year ended December 31, 2022 was primarily from providing training materials and clinical trial products to the Company's licensees. License revenue for the year ended December 31, 2021 was primarily a result of (i) the milestone payments from Bausch that consisted of $ 5.0 million received upon FDA approval of XIPERE, the recognition of $ 5.0 million of deferred revenue for the upfront milestone payment and the recognition of a $ 10.0 million milestone for pre-launch activities and (ii) an aggregate of $ 8.0 million received from Arctic Vision for FDA approval of XIPERE, territory expansion and certain development milestones. Segment Information Operating segments are defined as components of an enterprise about which separate discrete information is available for evaluation by the chief operating decision maker, or decision-making group, in deciding how to allocate resources and in assessing performance. The Company views its operations and manages its business in one operating segment. Property and Equipment, Net Property and equipment is recorded at historical cost. Depreciation is calculated using the straight-line method over the estimated useful lives of the related assets, or for leasehold improvement the lesser of the useful life or remaining lease term. Repairs and maintenance are expensed when incurred. Upon retirement or sale, the cost of the assets disposed of and the related accumulated depreciation are removed from the accounts, and any resulting gain or loss is included in the determination of net income. Debt Discount All debt discounts are recorded against the related debt obligation and are amortized using the effective interest rate method over the term of the underlying debt obligation and reflected in interest expense. Income Taxes Deferred tax assets or liabilities are recorded for temporary differences between financial statement and tax basis of assets and liabilities, using enacted rates in effect for the year in which the differences are expected to reverse. A valuation allowance is recorded if it is more likely than not that a deferred tax asset will not be realized. The Company has provided a full valuation allowance on its deferred tax assets, which primarily consist of cumulative net operating losses for the period from May 26, 2011 (inception) to December 31, 2023. Due to its history of operating losses since inception and losses expected to be incurred in the foreseeable future, a full valuation allowance was considered necessary. Liabilities for uncertain tax positions are recognized based on a two-step process. The first step is to evaluate the tax position for recognition by determining if the weight of available evidence indicates that it is more likely than not that the position will be sustained on audit, including resolution of related appeals or litigation processes, if any. Once it is determined that the position meets the recognition threshold, the second step requires estimating and measuring the largest amount of tax benefit that is more likely than not to be realized upon ultimate settlement. The difference between the amount of recognizable tax benefit and the total amount of tax benefit from positions filed or to be filed with the tax authorities is recorded as a liability for uncertain tax benefits. Research and Development Costs Research and development costs are charged to expense as incurred and include: • employee-related expenses, including salaries, benefits, travel and share-based compensation expense for research and development personnel; • expenses incurred under agreements with contract research organizations, contract manufacturing organizations and consultants that conduct preclinical studies and clinical trials; • costs associated with preclinical and clinical development activities; • costs associated with submitting regulatory approval applications for the Company’s product candidates; • costs associated with training physicians on the suprachoroidal injection procedure and educating and providing them with appropriate product candidate information; • costs associated with technology and intellectual property licenses; • costs for the Company’s research and development facility; and • depreciation expense for assets used in research and development activities. Costs for certain development activities, such as clinical trial activities, are recognized based on an evaluation of the estimated total costs for the clinical trial, progress to completion of specific tasks, using data such as patient enrollment, pass through expenses, clinical site activations, data from the clinical sites or information provided to the Company by its vendors on their actual costs incurred. Payments for these activities are based on the terms of the individual contracts and any subsequent amendments, which may differ from the patterns of costs incurred, and are reflected in the financial statements as prepaid or accrued expenses. Share-Based Compensation Compensation cost related to share-based awards granted to employees, directors and consultants is measured based on the estimated fair value of the award at the grant date. The fair value of restricted stock units granted is measured based on the market value of the Company’s common stock on the date of grant. Share-based compensation costs are expensed on a straight-line basis over the relevant vesting period. Compensation cost related to shares purchased through the Company’s employee stock purchase plan, which is considered compensatory, is based on the estimated fair value of the shares on the offering date, including consideration of the discount and the look back period. The Company estimates the fair value of the shares using a Black-Scholes option pricing model. Compensation expense is recognized over the six-month withholding period prior to the purchase date. All share-based compensation costs are recorded in general and administrative or research and development costs in the statements of operations based upon the underlying employees’ roles within the Company. Cash Equivalents Cash equivalents consist of short-term, highly liquid investments with an original term of three months or less at the date of purchase. Restricted Cash The Company is required to maintain a stand-by letter of credit as a security deposit for its facility lease in Alpharetta, Georgia. The Company’s bank requires the Company to maintain a restricted cash balance to serve as collateral for the letter of credit issued to the landlord by the bank. As of December 31, 2022, the restricted cash balance was invested in a commercial money market account. The current portion of the restricted cash is recorded in other current assets and the long-term portion is recorded in restricted cash. Concentration of Credit Risk Arising From Cash Deposits in Excess of Insured Limits The Company maintains its cash in bank deposits that at times may exceed federally insured limits. The Company has not experienced any loss in such accounts. The Company believes it is not exposed to any significant risks with respect to its cash balances. Liability Related to the Sales of Future Royalties and Non-Cash Interest Expense In connection with the Purchase and Sale Agreement, the Company recognized a liability related to the sales of future royalties under ASC 470-10 Debt and ASC 835-30 Interest - Imputation of Interest. The initial funds received by the Company pursuant to the terms of the Purchase and Sale Agreement were recorded as a liability and are accreted under the effective interest method up to the estimated amount of future royalties and milestone payments to be made under the Purchase and Sale Agreement. The issuance costs were recorded as a direct deduction to the carrying amount of the liability and are being amortized under the effective interest method over the estimated period the liability will be repaid. The Company estimates the total amount of future royalty revenue and milestone payments to be generated over the life of the Purchase and Sale Agreement, and a significant increase or decrease in these estimates could materially impact the liability balance and the related interest expense. If the timing of the receipt of royalty payments or milestones is materially different from the original estimates, the Company will prospectively adjust the effective interest and the related amortization of the liability and related issuance costs.

Property and Equipment, Net

Property and Equipment, Net	12 Months Ended
	Dec. 31, 2023
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	3. Property and Equipment, Net Property and equipment, net consisted of the following (dollar amounts in thousands): Estimated December 31, 2023 2022 Furniture and fixtures 5 $ 249 $ 249 Machinery and equipment 5 581 343 Computer equipment 3 20 13 Leasehold improvements Lesser of or 476 476 Work in process 2,590 527 Total property and equipment 3,916 1,608 Less: Accumulated depreciation ( 920 ) ( 853 ) Property and equipment, net $ 2,996 $ 755

Accrued Liabilities

Accrued Liabilities	12 Months Ended
	Dec. 31, 2023
Payables and Accruals [Abstract]
Accrued Liabilities	4. Accrued Liabilities Accrued liabilities consisted of the following (in thousands): December 31, 2023 2022 Accrued research and development $ 2,078 $ 1,817 Accrued employee costs 1,862 1,837 Accrued professional fees 38 49 Accrued expense 191 476 $ 4,169 $ 4,179

Royalty Purchase and Sale Agree

Royalty Purchase and Sale Agreement	12 Months Ended
	Dec. 31, 2023
Royalty Purchase and Sales Agreement [Abstract]
Royalty Purchase and Sale Agreement	5. Royalty Purchase and Sale Agreement On August 8, 2022 (the “Closing Date”), the Company, through its wholly-owned subsidiary Clearside Royalty LLC, a Delaware limited liability company (“Royalty Sub”), entered into a Purchase and Sale Agreement (the “Purchase and Sale Agreement”) with entities managed by HealthCare Royalty Management, LLC (“HCR”), pursuant to which Royalty Sub sold to HCR certain of its rights to receive royalty and milestone payments payable to Royalty Sub under the Arctic Vision License Agreement, the Bausch License Agreement, that certain License Agreement, effective as of July 3, 2019, by and between the Company and Aura Biosciences, Inc. (the “Aura License Agreement”), that certain Option and License Agreement, dated as of August 29, 2019, by and between REGENXBIO Inc. and the Company (the “REGENXBIO License Agreement”) and any and all out-license agreements following the Closing Date for, or related to XIPERE or the SCS Microinjector technology (to be used in connection with compounds or products of any third parties) delivered, in whole or in part, by means of the SCS Microinjector technology), excluding, for the avoidance of doubt, any in-licensed or internally developed therapies following the Closing Date (collectively, the “Royalties”), in exchange for up to $ 65 million. In connection with this transaction, the Company assigned the Arctic Vision License Agreement, Bausch License Agreement, Aura License Agreement, REGENXBIO License Agreement, the Company's license agreement with Emory University and The Georgia Tech Research Corporation and related intellectual property rights to Royalty Sub. Under the terms of the Purchase and Sale Agreement, Royalty Sub received an initial payment of $ 32.1 million, representing the $ 32.5 million to which the Company was entitled, net of certain of HCR's transaction-related expenses which the Company agreed to reimburse. There were additional issuance costs of $ 1.5 million related to the Purchase and Sale Agreement resulting in net proceeds of $ 30.6 million. An additional $ 12.5 million (the "First Milestone Payment") was deposited by HCR in an escrow account which was released to HCR pursuant to the Letter Agreement described below. The terms of the Purchase and Sale Agreement also provide for an additional $ 20 million milestone payment to Royalty Sub upon attainment of a second pre-specified sales milestone related to 2024 XIPERE sales (the "Second Milestone Event"). The Purchase and Sale Agreement will automatically expire, and the payment of Royalties from the Royalty Sub to HCR will cease, when HCR has received payments of the Royalties equal to 2.5 times the aggregate amount of payments made by HCR under the Agreement if the Second Milestone Event is achieved on or prior to December 31, 2024 (the “Initial Cap”). If the Second Milestone Event is not achieved on or prior to December 31, 2024, payment of Royalties from Royalty Sub to HCR will cease when HCR has received Royalties payments equal to 3.4 times the aggregate amount of payments under the Purchase and Sale Agreement (the “Alternative Cap”, and together with the Initial Cap, the “Cap Amount”). In the event of a change in control, acquiror will have the option to make a payment to HCR of the Cap Amount then in effect, less the aggregate amount of Royalty payments made by Royalty Sub to HCR under the Purchase and Sale Agreement as a one-time payment at which time, payment of Royalties to HCR will cease. Alternatively, in the event of a change in control, the acquiror will have the option to make an initial payment of 1.0 times the aggregate amount of payments made by HCR under the Purchase and Sale Agreement as of the date of such change in control, then in that event, payment of Royalties from Royalty Sub to HCR will cease when HCR has received total Royalties payments (including the initial payment) equal to the Alternative Cap. After the Purchase and Sale Agreement expires, all rights to receive the Royalties return to Royalty Sub. On December 22, 2023, the Company, through its wholly owned subsidiary Royalty Sub, entered into the Letter Agreement with the Agent amending that certain Purchase and Sale Agreement, dated as of August 8, 2022, by and among Royalty Sub, HCR and Agent. Pursuant to the terms of the Letter Agreement, Royalty Sub and Agent mutually agreed that Royalty Sub waived any and all rights to the First Milestone Payment in connection with the closing of the transactions contemplated by the Purchase and Sale Agreement and agreed to the release of the First Milestone Payment to Agent. Issuance costs pursuant to the Purchase and Sale Agreement consisting primarily of advisory and legal fees, totaled $ 1.9 million including the amount of HCR's transaction-related expenses that the Company reimbursed. The effective interest rate includes cash flow projections for future royalty and milestone payments that are forward looking and could be affected by future market conditions. The Company estimates the amount and timing of expected payments based on historical experience and its expectations of future activities from its license partners, as well as current market conditions. The following table summarizes the activity of the Purchase and Sale Agreement (in thousands): Balance at December 31, 2022 $ 33,977 Payments ( 1,350 ) Non-cash interest expense 9,361 Balance at December 31, 2023 $ 41,988 Effective interest rate 23.3 %

CARES Act Paycheck Protection P

CARES Act Paycheck Protection Program Loan	12 Months Ended
	Dec. 31, 2023
Unusual or Infrequent Items, or Both [Abstract]
CARES Act Paycheck Protection Program Loan	6. CARES Act Paycheck Protection Program Loan On April 20, 2020, the Company entered into a loan agreement with SVB (the “PPP Lender”) under the terms of which the PPP Lender made a loan to the Company in an aggregate principal amount of $ 1.0 million (the “PPP Loan”) pursuant to the Paycheck Protection Program (the “PPP”) under the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”). The PPP Loan was evidenced by a promissory note (the “Note”) containing the terms and conditions for repayment of the PPP Loan. Under the terms of the Note and the PPP Loan, interest accrued on the outstanding principal amount at the rate of 1.0 % per annum. The term of the Note was until April 2022 , with the Company obligated to make equal monthly payments of principal and interest, beginning in November 2020 and continuing until the maturity date. The CARES Act and the PPP provide a mechanism for forgiveness of up to the full amount borrowed. On January 11, 2021, the Company was notified by the PPP Lender that the PPP Loan had been forgiven in full, including approximately $ 7,000 of accrued interest. In accordance with ASC 405-20, Extinguishment of Liabilities , the income from the forgiveness of the amount borrowed and the accrued interest was recognized in the statement of operations in other income as a gain on extinguishment of debt.

Preferred and Common Stock

Preferred and Common Stock	12 Months Ended
	Dec. 31, 2023
Equity [Abstract]
Preferred and Common Stock	7. Preferred and Common Stock The Company’s amended and restated certificate of incorporation authorizes the Company to issue 10,000,000 shares of $ 0.001 par value of preferred stock. As of December 31, 2023 and 2022, there were 10,000,000 shares of preferred stock authorized, no ne of which were issued and outstanding. At the Company's Annual Meeting of Stockholders held on June 22, 2022, the Company's stockholders approved an amendment to the amended and restated certificate of incorporation to increase the Company's authorized number of shares of common stock from 100,000,000 shares to 200,000,000 shares. As of December 31, 2023 the Company was authorized to issue 200,000,000 shares of $ 0.001 par value common stock. As of December 31, 2023 and 2022, there were 62,850,841 and 60,639,827 shares of common stock outstanding, respectively.

Common Stock Warrants

Common Stock Warrants	12 Months Ended
	Dec. 31, 2023
Common Stock Warrants [Abstract]
Common Stock Warrants	8. Common Stock Warrants In September 2016, in connection with a loan agreement, the Company issued warrants to the lenders to purchase up to 29,796 shares of common stock at a price per share of $ 10.74 . The warrants are fully exercisable and expire in September 2026 , or earlier upon the occurrence of specified mergers or acquisitions of the Company. The warrants were recorded in equity at the time of issuance and had a remaining life of 2.75 years as of December 31, 2023. On February 6, 2024, the Company entered into a securities purchase agreement with institutional investors and an existing stockholder, pursuant to which the Company issued and sold, in a registered direct offering (i) an aggregate of 11,111,111 shares (the “Shares”) of its common stock; and (ii) warrants to purchase up to 11,111,111 shares of common stock (the “Warrants”). The combined purchase price of each Share and accompanying Warrant was $ 1.35 . The exercise price for the Warrants is $ 1.62 per share. The Warrants will be exercisable from August 9, 2024 and will expire on August 9, 2029 .

Share-Based Compensation

Share-Based Compensation	12 Months Ended
	Dec. 31, 2023
Share-Based Payment Arrangement [Abstract]
Share-Based Compensation	. Share-Based Compensation Stock Options In January 2016, the Company’s board of directors adopted and approved the Clearside Biomedical, Inc. 2016 Equity Incentive Plan (the “2016 Plan”) which became effective on June 1, 2016. The 2016 Plan provides for the grant of share-based awards to employees, directors and consultants of the Company. The 2016 Plan provides for the grant of incentive stock options to employees, and for the grant of nonqualified stock options, restricted stock awards, restricted stock unit awards, stock appreciation rights, performance stock awards and other forms of stock compensation to the Company’s employees, directors, and non-employee third parties. The number of shares of common stock reserved for issuance under the 2016 Plan will automatically increase on January 1 each year, through January 1, 2026, by 4 % of the total number of shares of the Company’s common stock outstanding on December 31 of the preceding calendar year, or a lesser number of shares as may be determined by the Company’s board of directors. At December 31, 2023, under the 2016 Plan, options to purchase 9,638,424 shares of the Company’s common stock were outstanding at a weighted average price of $ 2.79 per share and 570,024 shares remained available for future grant. As of January 1, 2024, the number of shares of common stock that may be issued under the 2016 Plan was automatically increased by 2,514,033 shares, representing 4 % of the total number of shares of common stock outstanding on December 31, 2023, increasing the number of shares of common stock available for issuance under the 2016 Plan as of that date to 3,084,057 shares. As a result of the adoption of the 2016 Plan, no further grants may be made under the Company’s 2011 Stock Incentive Plan (the “2011 Plan”). The 2011 Plan provided for the grant of share-based awards to employees, directors and consultants of the Company. At December 31, 2023, options to purchase 210,110 shares of the Company’s common stock were outstanding under the 2011 Plan at a weighted average exercise price of $ 4.28 per share. The Company has granted stock option awards to employees, directors and consultants. The total share-based compensation expense recognized is reflected in the statements of operations as follows (in thousands): Year Ended 2023 2022 2021 Research and development $ 1,200 $ 1,616 $ 1,570 General and administrative 1,758 1,785 1,985 Total $ 2,958 $ 3,401 $ 3,555 Share-based compensation is accounted for in accordance with the provisions of ASC 718, Compensation-Stock Compensation . The estimated fair value of options granted is determined as of the date of grant using the Black-Scholes option pricing model. The resulting fair value is recognized ratably over the requisite service period, which is generally the vesting period of the awards. The following table sets forth the weighted average assumptions utilized in the Black-Scholes option pricing model to calculate the fair value of the underlying common stock for the years ended December 31, 2023, 2022 and 2021. Year Ended 2023 2022 2021 Expected term (years) 6.00 6.00 7.00 Expected stock price volatility 95.55 % 98.24 % 101.43 % Risk-free interest rate 4.07 % 2.09 % 0.75 % Expected dividend yield 0.00 % 0.00 % 0.00 % Expected term (in years): In the years ended December 31, 2023 and 2022, the Company used historical data to calculate the expected term. In the year ended December 31, 2021, the Company utilized the simplified method as prescribed by ASC 718, as the Company did not have sufficient historical exercise and post-vesting termination data to provide a reasonable basis upon which to estimate the expected term of stock options granted to employees. Risk-free interest rate : The risk-free interest rate is based on the yields of U.S. Treasury securities with maturities similar to the expected time to a possible liquidity event. Expected dividend yield : The Company has not paid and does not anticipate paying any dividends in the foreseeable future. Expected stock price volatility : The Company calculates expected volatility based on the historical volatility of its common stock. Forfeitures: The Company records forfeitures as they occur. The following table summarizes the activity related to stock options during the year ended December 31, 2023: Weighted Number of Average Shares Exercise Price Options outstanding at December 31, 2022 6,915,330 $ 3.58 Granted 3,684,750 1.28 Exercised ( 81,816 ) 0.40 Forfeited or expired ( 652,494 ) 2.32 Options outstanding at December 31, 2023 9,865,770 2.83 Options exercisable at December 31, 2022 4,223,931 4.22 Options exercisable at December 31, 2023 5,494,746 3.83 The following table provides additional information about the Company’s stock options that were outstanding and exercisable at December 31, 2023 (aggregate intrinsic values in thousands): Weighted Weighted Weighted Average Weighted Average Average Aggregate Remaining Average Aggregate Remaining Exercise Options Exercise Intrinsic Contractual Options Exercise Intrinsic Contractual Price Outstanding Price Value Life (Years) Exercisable Price Value Life (Years) $ 0.00 - $ 2.99 6,879,914 7.64 2,836,713 5.73 $ 3.00 - $ 6.99 2,364,770 5.11 2,036,947 4.79 $ 7.00 - $ 8.99 419,308 3.18 419,308 3.18 $ 9.00 - $ 20.84 201,778 3.76 201,778 3.76 9,865,770 $ 2.83 $ 363 6.77 5,494,746 $ 3.83 $ 11 5.12 As of December 31, 2023, the Company had $ 4.1 million of unrecognized compensation expense related to unvested stock options, which is expected to be recognized over a weighted average period of 2.3 years. The weighted average fair values of all stock options granted for the years ended December 31, 2023, 2022 and 2021 was $ 0.98 per share, $ 1.55 per share and $ 3.24 per share, respectively. The intrinsic value is calculated as the difference between the fair market value and the exercise price per share of the stock options. The fair market value per share of common stock as of December 29, 2023 was $ 1.17 , which was the closing sale price of the Company’s common stock on the Nasdaq Global Market on that date. Restricted Stock Units The Company has granted restricted stock units (“RSUs”) to employees under the 2016 Plan. The shares underlying the RSU awards have vesting terms of four years from the date of grant, subject to the employees’ continuous service and subject to accelerated vesting in specified circumstances. The fair value of the RSUs granted is measured based on the market value of the Company’s common stock on the date of grant and is recognized ratably over the requisite service period, which is generally the vesting period of the awards. The total share-based compensation expense related to RSUs is reflected in the statements of operations as follows (in thousands): Year Ended 2023 2022 2021 Research and development $ 585 $ 794 $ 723 General and administrative 646 658 715 Total $ 1,231 $ 1,452 $ 1,438 The following table summarizes the activity related to RSUs during the year ended December 31, 2023: Weighted Average Number of Grant Date Shares Fair Value Non-vested RSUs outstanding at December 31, 2022 1,462,932 $ 3.04 Granted — — Vested ( 471,390 ) 3.09 Forfeited ( 156,643 ) 3.09 Non-vested RSUs outstanding at December 31, 2023 834,899 3.01 As of December 31, 2023, the Company had $ 1.3 million of unrecognized compensation expense related to the RSUs, which amount is expected to be recognized over a weighted average period of 1.5 years. Employee Stock Purchase Plan In January 2016, the Company’s board of directors adopted and approved the Clearside Biomedical, Inc. 2016 Employee Stock Purchase Plan (the “2016 ESPP”) which became effective on June 1, 2016. The 2016 ESPP permits employees to purchase shares of the Company’s common stock through payroll deductions up to 15 % of their earnings. The number of shares reserved for issuance under the 2016 ESPP will automatically increase on January 1 of each year, through January 1, 2026, by the lesser of (i) 1% of the total number of shares of the Company’s common stock outstanding on December 31 of the preceding calendar year, (ii) 454,545 shares of common stock or (iii) a lesser number of shares as may be determined by the Company’s board of directors . The Company’s board of directors elected not to increase the shares reserved for issuance on January 1, 2024. The number of shares of common stock available for issuance under the 2016 ESPP as of December 31, 2023 was 348,782 shares. The 2016 ESPP is considered a compensatory plan and the fair value of the discount and the look-back period are estimated using the Black-Scholes option pricing model and expense is recognized over the six-month withholding period prior to the purchase date. During the years ended December 31, 2023, 2022 and 2021, the Company issued 68,109 , 66,919 and 65,481 shares, respectively, of common stock purchased under the 2016 ESPP. The share-based compensation expense recognized for the 2016 ESPP is reflected in the statements of operations and comprehensive loss as follows (in thousands): Year Ended 2023 2022 2021 Research and development $ 10 $ 21 $ 41 General and administrative 3 10 20 Total $ 13 $ 31 $ 61

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Income Taxes	10. Income Taxes Deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. Significant components of the Company’s net deferred income tax assets consist of the following (in thousands): December 31, 2023 2022 2021 Deferred tax asset (liability): Net operating loss carryforwards $ 52,657 $ 50,267 $ 53,966 Non-deductible accrued expenses 562 386 469 Right-of-use asset ( 210 ) ( 238 ) ( 96 ) Lease liability 246 274 176 Stock compensation expense 3,339 2,678 2,768 Depreciation differences ( 71 ) ( 40 ) ( 44 ) Federal tax credits 10,908 9,742 9,012 State tax credits 342 326 342 Royalty purchase and sale agreement 10,495 7,247 — Capitalized research and development expenses 5,777 3,057 — Valuation allowance ( 84,045 ) ( 73,699 ) ( 66,599 ) Net deferred tax asset $ — $ — $ ( 6 ) A reconciliation of the statutory tax rates and the effective tax rates is as follows: Year Ended December 31, 2023 2022 2021 U.S. federal tax rate 21.00 % 21.00 % 21.00 % State tax rate 8.59 ( 0.85 ) ( 599.32 ) Permanent difference ( 1.44 ) ( 1.34 ) ( 3.15 ) Tax credit 3.64 2.18 ( 253.97 ) Valuation allowance ( 31.85 ) ( 21.57 ) 847.82 ASC 740-10 — — ( 3.19 ) Adjustment to prior year tax provision — 0.67 ( 13 ) Other 0.06 ( 0.09 ) 3.97 0.00 % 0.00 % 0.00 % Certain items of income and expense are not reported in tax returns and financial statements in the same year. The tax effect of such temporary differences is reported as deferred income taxes. The measurement of deferred tax assets is reduced, if necessary, by the amount of any tax benefit that, based on available evidence, is not expected to be realized. The Company establishes a valuation allowance for deferred tax assets for which realization is not likely. As of each reporting date, management considers new evidence, both positive and negative, that could affect its view of the future realization of deferred tax assets. At December 31, 2023, the Company had a valuation allowance of $ 84.0 million recorded against the benefit of certain deferred tax assets. The valuation allowance was primarily related to federal and state net operating loss ("NOL") carryforwards that, in the judgment of management, are not more likely than not to be realized. In assessing the recoverability of the Company’s deferred tax assets, management considered, among other things, its deferred tax liabilities, its historical earnings and losses, projections of future income, and tax-planning strategies available to the Company in the relevant jurisdiction. The Company will release this valuation allowance when management determines that it is more likely than not that its deferred tax asset will be realized. At December 31, 2023, the Company had income tax NOL carryforwards for federal and state purposes of $ 225.9 million and $ 89.3 million, respectively. The Company has recorded a deferred tax asset for both federal and state NOL carryforwards of $ 47.4 million and $ 5.6 million, respectively. If not utilized, the federal NOL carryforwards will begin to expire beginning in 2034 , and the state NOL carryforwards will begin to expire at various dates beginning in 2027 . Additionally, under the 2017 Tax Cuts and Jobs Act, federal net operating losses incurred in 2018 and beyond may be carried forward indefinitely. However, the deductibility of such federal net operating losses is limited beginning in 2021. Certain states have also adopted the indefinite carryforward period beginning with the 2018 tax year, but state conformity varies state by state. Liabilities for uncertain tax positions are recognized based on a two-step process. The first step is to evaluate the tax position for recognition by determining if the weight of available evidence indicates that it is more likely than not that the position will be sustained on audit, including resolution of related appeals or litigation processes, if any. Once it is determined that the position meets the recognition threshold, the second step requires the Company to estimate and measure the largest amount of tax benefit that is more likely than not to be realized upon ultimate settlement. The difference between the amount of recognizable tax benefit and the total amount of tax benefit from positions filed or to be filed with the tax authorities is recorded as a liability for uncertain tax benefits. The following is a roll forward of the Company’s uncertain tax positions (in thousands): Year Ended December 31, 2023 2022 Balance of uncertain tax positions at the beginning of the year $ 7,520 $ 7,520 Gross decreases - tax positions in prior period — — Gross decreases - settlements with taxing authorities — — Balance of uncertain tax positions at the end of the year $ 7,520 $ 7,520 As of December 31, 2023 and 2022, there was $ 7.5 million in each period of unrecognized tax benefit that if recognized would be in the form of a net operating loss carryforward, which is expected to require a full valuation allowance based on present circumstances. The Company reversed $ 48,000 of previously recorded unrecognized tax expenses for the year 2021. The Company recognizes accrued interest related to unrecognized tax expenses and penalties as income tax expense. No significant amounts of interest or penalties have been recorded as of December 31, 2023. Ownership changes, as defined by Section 382 of the Internal Revenue Code of 1986, as amended (the “Code”), may limit the amount of net operating losses that a company may utilize to offset future taxable income and taxes payable. In general, if the Company experiences a greater than 50% aggregate change in ownership over a 3-year period (a Section 382 ownership change), utilization of the Company’s pre-change NOL carryforwards may be subject to limitation under the Code. The annual limitation generally is determined by multiplying the value of the Company’s stock at the time of such ownership change (subject to certain adjustments) by the applicable long-term tax-exempt rate for the month in which the ownership change occurred. Such limitation may result in expiration of a portion of the NOL carryforwards before utilization. The Company has completed an owner shift analysis to determine the dates in which the Company may have experienced a Section 382 ownership change, and determined that the Company experienced ownership changes for Section 382 purposes in January 2012, December 2013, and July 2016. Further, the Company has determined that $ 38,000 and $ 2,000 of its deferred tax asset related to Federal NOL and Federal R&D Credit, respectively, will expire due to Section 382. The NOL DTA has a full valuation allowance as it is deemed that it is more likely than not to be utilized. The Company will continue to monitor equity movement and its impact on the utilization of the NOLs and credits. The Company’s ability to use the remaining NOL carryforwards may be further limited if the Company experiences an additional Section 382 ownership change as a result of future changes in its stock ownership. The Company is subject to taxation in the United States and certain state jurisdictions. As of December 31, 2023, the Company’s tax returns for 2020, 2021 and 2022 are subject to full examination by the tax authorities. As of December 31, 2023, the Company is generally no longer subject to state or local examinations by tax authorities for years before 2020, except to the extent of NOLs generated in prior years claimed on a tax return.

Commitment and Contingencies

Commitment and Contingencies	12 Months Ended
	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	11. Commitments and Contingencies Lease Commitment Summary The Company leases its facilities and some of its equipment under noncancelable operating lease arrangements that expire at various dates through 2026. In November 2022, the Company singed an amended office lease agreement and decreased the square footage to approximately 14,000 square feet. The amended office lease agreement is for a four-year term with a renewal option for an additional thirty-eight months . Rental payments are $ 30,437 per month subject to an increase of 3 % per year. Operating lease cost under this lease and the amendment is recognized on a straight-line basis over the term of the lease. In addition, the office lease agreement requires payment of the pro-rata share of the annual operating expenses associated with the premises. The Company’s operating leases included on the balance sheet are as follows (in thousands): December 31, Operating lease right-of-use asset $ 869 Liabilities Current portion of operating lease liabilities $ 364 Operating lease liabilities 649 Total operating lease liabilities $ 1,013 The Company recognizes a right-of-use asset for the right to use the underlying asset for the lease term, and a lease liability, which represents the present value of the Company’s obligation to make payments over the lease term. The renewal option is not included in the calculation of the right-of-use asset and the lease liabilities as the Company is not reasonably certain if the Alpharetta, Georgia lease will be renewed. The present value of the lease payments is calculated using an incremental borrowing rate as the Company’s leases do not provide an implicit interest rate. At December 31, 2023, the Company’s incremental borrowing rate was 8.0 % and the remaining lease term was 3.0 years. Cash payments included in operating activities on the consolidated statement of cash flows for operating lease liabilities were $ 362,000 , $ 339,000 and $ 392,000 for the years ended December 31, 2023, 2022 and 2021, respectively. Minimum lease payments were as follows at December 31, 2023 (in thousands): Year ending December 31, 2024 $ 378 2025 389 2026 367 Total minimum lease payments 1,134 Less imputed interest ( 121 ) Total operating lease liabilities $ 1,013 Equipment leases with an initial term of 12 months or less are not recorded with operating lease liabilities. The Company recognizes expense for these leases on a straight-line basis over the lease term. The equipment leases were deemed to be immaterial. Operating lease cost was $ 339,000 , $ 262,000 and $ 247,000 for the years ended December 31, 2023, 2022 and 2021. Variable lease cost was $ 19,000 , $ 87,000 and $ 95,000 for the years ended December 31, 2023, 2022 and 2021. Short-term lease cost was $ 93,000 , $ 86,000 and $ 12,000 for the years ended December 31, 2023, 2022 and 2021, respectively. Georgia Tech License Agreement As described in Footnote 1, the Company entered into a fourth amendment to the Georgia Tech License Agreement pursuant to which the parties agreed to revised Maintenance Fee payments. The Company paid the Maintenance Fee for 2023 in February 2024. The remaining annual Maintenance Fee payments are due on October 1st of each year from 2024 through 2028, as show in the table below. The annual Maintenance Fee will be paid as follows (in thousands): Year Ending December 31, 2024 $ 250 2025 250 2026 350 2027 400 2028 500 $ 1,750 Contract Service Providers In the course of the Company’s normal business operations, it has agreements with contract service providers to assist in the performance of its research and development, clinical research and manufacturing. Substantially all of these contracts are on an as needed basis. In May 2018, the Company entered into a manufacturing supply agreement (the “Supply Agreement”), with Gerresheimer Regensburg GmbH, a company incorporated under the laws of Germany (“Gerresheimer”). Gerresheimer will manufacture and supply the Company’s proprietary SCS Microinjector. The Company will provide Gerresheimer with a rolling forecast schedule of its projected purchase orders for at least the next four calendar quarters. The Supply Agreement contains an initial five-year term that will automatically renew for successive periods of three years , unless terminated by either party at least 12 months prior to the end of the applicable term.

License and Other Agreements

License and Other Agreements	12 Months Ended
	Dec. 31, 2023
License And Other Agreement [Abstract]
License and Other Agreements	12. License and Other Agreements Bausch + Lomb On October 22, 2019, the Company entered into a License Agreement (as amended, the "Bausch License Agreement") with Bausch + Lomb, a division of Bausch Health Companies, Inc. (“Bausch”). Pursuant to the Bausch License Agreement, the Company has granted an exclusive license to Bausch to develop, manufacture, distribute, promote, market and commercialize XIPERE using the Company’s proprietary SCS Microinjector (the “Device”), as well as specified other steroids, corticosteroids and NSAIDs in combination with the Device (“Other Products,” and together with XIPERE, the “Products”), subject to specified exceptions, in the United States and Canada (the “Territory”) for the treatment of ophthalmology indications, including non-infectious uveitis. Pursuant to the Bausch License Agreement, Bausch paid the Company an upfront payment of $ 5.0 million (the “Upfront Payment”) in October 2019. In October 2021, the FDA approved XIPERE. The Company received $ 5.0 million from Bausch as a result of the approval. In December 2021, $ 10.0 million was recorded upon completion of pre-launch activities for XIPERE and payment was received in January 2022. In addition, Bausch has agreed to pay up to an aggregate of $ 55.0 million in additional milestone payments upon the achievement of (i) specified regulatory approvals for specified additional indications of XIPERE and (ii) specified levels of annual net sales (as defined in the Bausch License Agreement). Further, during the applicable royalty term, the Company will also be entitled to receive tiered royalties at increasing percentages, from the high-teens to twenty percent, based on XIPERE achieving certain annual net sales thresholds in the Territory, in each case subject to reductions in specified circumstances; provided that the Company will not receive any royalties on the first $ 45.0 million of cumulative net sales of all products in the Territory. Bausch launched XIPERE in the United States in the first quarter of 2022. The Company's rights to these royalties and milestone payments have been sold pursuant to the terms and conditions of the Purchase and Sale Agreement described in Note 5 to the consolidated financial statements. The Company was responsible for all development expenses for XIPERE in the Territory until the Company's New Drug Application ("NDA") was approved by the FDA, subject to specified exceptions, as well as manufacturing costs in connection with the NDA. The Company was also responsible for all clinical and development expenses conducted to satisfy the FDA’s requests in the complete response letter issued on October 18, 2019 related to the NDA and any subsequent complete response letter related to the NDA. Following FDA approval of XIPERE, Bausch is responsible for all such expenses. Due to the refund provisions in the Bausch License Agreement, the Upfront Payment was included on the balance sheet as deferred revenue as of December 31, 2020. The refund provisions lapsed upon FDA approval of XIPERE and the $ 5.0 million was recognized as revenue in the fourth quarter of 2021. REGENXBIO, Inc . On August 29, 2019, the Company entered into an option and license agreement with REGENXBIO, Inc. (“REGENXBIO”) pursuant to which the Company granted REGENXBIO an exclusive option to enter into a commercial license agreement (the “Option”), which grants REGENXBIO an exclusive, worldwide and sublicensable license to the Company’s SCS Microinjector for the delivery of adeno-associated virus-based gene therapies for the treatment of wet age-related macular degeneration, diabetic retinopathy and other conditions for which anti-vascular endoth elial growth factor treatment is currently the standard of care. REGENXBIO exercised the Option in October 2019 and paid the Company an option fee equal to $ 2.0 million, less a credit of $ 0.5 million previously received under a technology access agreement. In addition, REGENXBIO has agreed to pay the Company up to an aggregate of $ 31.0 million in milestone payments upon the achievement of specified development milestones and up to an aggregate of $ 102.0 million in sales-based milestone payments, as well as mid-single digit royalties on net sales of products using the SCS Microinjector during the royalty term. In September 2020, the Company received $ 3.0 milli on in milestone payments under the Option. The Company's rights to these royalties and milestone payments have been sold pursuant to the terms and conditions of the Purchase and Sale Agreement described in Note 5 to the consolidated financial statements. Arctic Vision (Hong Kong) Limited On March 10, 2020, the Company entered into a License Agreement (the “Arctic Vision License Agreement”) with Arctic Vision (Hong Kong) Limited (“Arctic Vision”). Pursuant to the Arctic Vision License Agreement, the Company has granted an exclusive license to Arctic Vision to develop, distribute, promote, market and commercialize XIPERE, subject to specified exceptions in China, Hong Kong, Macau, Taiwan and South Korea (the “Arctic Territory”). Under the terms of the Arctic Vision License Agreement, neither party may commercialize XIPERE in the other party’s territory. Arctic Vision has agreed to use commercially reasonably efforts to pursue development and commercialization of XIPERE for indications associated with uveitis in the Arctic Territory. In addition, upon receipt of the Company’s consent, Arctic Vision will have the right, but not the obligation, to develop and commercialize XIPERE for additional indications in the Arctic Territory. Pursuant to the Arctic Vision License Agreement, Arctic Vision paid the Company an upfront payment of $ 4.0 million in March 2020. In December 2021, the Company received a milestone paym ent of $ 4.0 million following the receipt of FDA approval of XIPERE in the United States. In addition, Arctic Vision has agreed to pay the Company up to $ 22.5 million in development and sales milestones. Further, dur ing the applicable royalty term, the Company will also be entitled to receive tiered royalties of ten to twelve percent of net sales based on achieving certain annual net sales thresholds in the Arctic Territory, subject to customary reductions, payable on a product-by-product and country-by-country basis, commencing at launch in such country and lasting until the latest of (i) the date that all valid claims within the licensed patent rights covering XIPERE have expired, (ii) the date of the loss of marketing or regulatory exclusivity of XIPERE in a given country, or (iii) ten years from the first commercial sale of XIPERE in a given country. The Company's rights to these royalties and milestone payments have been sold pursuant to the terms and conditions of the Purchase and Sale Agreement described in Note 5 to the consolidated financial statements. In August 2021, the Company entered into an amendment to the Arctic Vision License Agreement to expand the territories covered by the license to include India and the ASEAN Countries (Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam). In September 2021, the Company entered into a second amendment to the Arctic Vision License Agreement to expand the Arctic Territory to include Australia and New Zealand. The Company received an aggregate of $ 3.0 million in consideration for the expansion of the Arctic Territory. BioCryst Pharmaceuticals, Inc. On November 1, 2023, the Company , entered into the BioCryst License Agreement pursuant to which the Company granted BioCryst an exclusive, worldwide and sublicensable license to the Company’s SCS Microinjector for the delivery of BioCryst’s proprietary plasma kallikrein inhibitor known as avoralstat for the treatment and prevention of DME. The Company received an upfront license fee payment of $ 5.0 million in connection with signing of the BioCryst License Agreement. In addition, the Company is eligible to receive up to an additional $ 30.0 million in clinical and regulatory milestone payments, and up to a total of $ 47.5 million in a series of post-approval sales-based milestone payments based on the achievement of annual global net product sales milestones up to $ 2.0 billion. Further, during the royalty term, BioCryst has also agreed to pay the Company tiered mid-single digit royalties on annual global net product sales, with the highest royalty rate applied to sales over $ 1.5 billion, subject to reductions in specified circumstances. The Company's rights to these royalties and milestone payments have been sold pursuant to the terms and conditions of the Purchase and Sale Agreement described in Note 5 to the consolidated financial statements. BioCryst will be responsible for all development, regulatory and commercialization activities for avoralstat. The Company is responsible for supplying SCS Microinjectors to meet BioCryst’s reasonable needs. The BioCryst License Agreement, unless earlier terminated, will expire (a) on a country-by-country basis upon the expiration of the royalty term in such country or (b) in its entirety upon the expiration of all payment obligations of BioCryst under the BioCryst License Agreement in all countries pursuant to clause (a). Each party has the right terminate the License Agreement (i) upon a material breach of the BioCryst License Agreement by the other party, subject to a specified cure period and specified exceptions, or (ii) if the other party encounters bankruptcy or insolvency. The Company may terminate the BioCryst License Agreement if BioCryst or any of its sublicensees (a “Sublicensee”) commences a legal action challenging the validity, enforceability or scope of any of the licensed patents, provided that with respect to any such action initiated by a Sublicensee (a “Sublicensee Action), the Company may terminate the BioCryst License Agreement if the Sublicensee Action is not terminated within a specified period of time following BioCryst’s receipt of written notice from the Company or if BioCryst does not terminate the applicable sublicense, in each case within a specified period of time. BioCryst may terminate the BioCryst License Agreement (i) immediately upon written notice to the Company if, after exercising commercially reasonable efforts, BioCryst determines in good faith that it is not advisable to continue development or commercialization of avoralstat as a result of a material safety issue and (ii) in its entirety or in part on a country-by-country basis, for any or no reason, upon prior written notice to the Company, provided that in the event of such a termination, BioCryst shall not, for a period of two years from the date of such a termination, initiate in the territory subject to the termination a Phase 3 clinical trial in which avoralstat is administered to the suprachoroidal space using a device other than the SCS Microinjector. Emory and Georgia Tech On January 31, 2024 (the “Amendment Execution Date”), the Company and the Licensor, entered into the Amendment to the Company’s License Agreement with Licensor dated July 4, 2012 (as amended, the “License Agreement”), pursuant to which the Company received a worldwide exclusive license to specified patents relating to methods and devices for drug delivery using a microinjector. Pursuant to the Amendment, the parties agreed to reduce the Sublicense Percentage (as defined in the License Agreement) from a low double digit percentage to a high single digit percentage that the Company will pay the Licensor applicable to any fees or payments paid to the Company by any Sublicensee (as defined in the License Agreement) of the Licensed Patents and/or Licensed Technology (each as defined in the License Agreement), on or after July 1, 2023, excluding (i) amounts paid to the Company by a Sublicensee to reimburse the Company for certain research and development costs pursuant to a written agreement between the Company and such Sublicensee, (ii) the value of intellectual property transferred or granted to the Company if necessary or helpful to the development or commercialization of Licensed Products (as defined in the License Agreement) and (iii) amounts paid for shares of the Company’s stock. The payment to Licensor of any such Sublicense Percentage is due within 30 days of receipt by the Company of a qualifying payment from a Sublicensee, provided however, with respect to any qualifying payments received by the Company from a Sublicensee after July 1, 2023 but prior to January 1, 2025, the payment to Licensor of any such Sublicensee Percentage is due to Licensor by March 31, 2025. In addition, the parties agreed to a revised annual license maintenance fee due each year, or the Maintenance Fee, starting in 2023 through 2028, as follows: $ 250,000 for 2023 through 2025, $ 350,000 for 2026, $ 400,000 for 2027 and $ 500,000 for 2028. The Company paid the Maintenance Fee for 2023 in February 2024. The remaining annual Maintenance Fee payments are due on October 1st of each year. Other The Company periodically enters into short-term agreements with other customers to evaluate the potential use of its proprietary SCS Microinjector with third-party product candidates for the treatment of various diseases. Funds received from these agreements are recognized as revenue over the term of the agreement. The Company recorded $ 50,000 , $ 13,000 and $ 200,000 of revenue from these agreements during the years ended December 31, 2023, 2022 and 2021, respectively.

Fair Value Measurements

Fair Value Measurements	12 Months Ended
	Dec. 31, 2023
Fair Value Disclosures [Abstract]
Fair Value Measurements	13. Fair Value Measurements The Company’s material financial instruments at December 31, 2023 and 2022, consisted primarily of cash and cash equivalents. The fair value of cash and cash equivalents, other current assets and accounts payable approximate their respective carrying values due to the short-term nature of these instruments and are classified as Level 1 in the fair value hierarchy. The fair value of liability related to the sales of future royalties approximates the carrying value. There were no transfers between Levels 1, 2 and 3 during the years ended December 31, 2023 and 2022.

Related Party Transactions

Related Party Transactions	12 Months Ended
	Dec. 31, 2023
Related Party Transactions [Abstract]
Summary of Related Party Transactions Disclosure	14. Related Party Transactions During 2023, a member of the Company's Board of Directors took a position as Chief Executive Officer of a company that is a vendor of the Company. As of December 31, 2023, the Company has recorded $ 331,000 in accounts payable and $ 215,000 in accrued expense with this vendor in the consolidated balance sheets. For the year ended December 31, 2023, the Company has recorded $ 1.1 million of expense in the consolidated statements of operations. The Chair of the Board of Directors of BioCryst also serves on the Company’s Board of Directors. For the year ended December 31, 2023, t here was $ 5.0 million related to the License Agreement recorded in license and other revenue in the consolidated statements of operations.

Net Income (Loss) Per Share

Net Income (Loss) Per Share	12 Months Ended
	Dec. 31, 2023
Earnings Per Share [Abstract]
Net Income (Loss) Per Share	15. Net (Loss) Income Per Share Basic net (loss) income per share is calculated by dividing the net (loss) income by the weighted average number of shares of common stock outstanding for the period, without consideration of the dilutive effect of potential common stock equivalents. Diluted net (loss) income per share gives effect to all dilutive potential shares of common stock outstanding during this period. For periods in which the Company incurred net losses, common stock equivalents were excluded which included stock options, unvested restricted stock and stock purchase warrants, have been excluded from the computation of diluted net loss per share as their inclusion would have the effect of reducing the net loss per share. Therefore, the denominator used to calculate both basic and diluted net loss per share is the same in all periods presented. Year Ended December 31, 2023 2022 2021 Net (loss) income - basic and diluted $ ( 32,485 ) $ ( 32,947 ) $ 376 Weighted average shares - basic 61,806,959 60,204,862 58,491,986 Effect of dilutive securities: Stock options — — 1,058,134 Restricted stock — — 342,943 ESPP — — 13,539 Weighted average shares - diluted 61,806,959 60,204,862 59,906,602 Net (loss) income per share - basic $ ( 0.53 ) $ ( 0.55 ) $ 0.01 Net (loss) income per share - diluted $ ( 0.53 ) $ ( 0.55 ) $ 0.01 The Company’s potential common stock equivalents that have been excluded from the computation of diluted net income (loss) per share for all periods presented because of their antidilutive effect consisted of the following: Year Ended 2023 2022 2021 Outstanding stock options 9,865,770 6,915,330 4,704,194 Non-vested restricted stock units 834,899 1,462,932 974,404 Stock purchase warrants 29,796 29,796 29,796 10,730,465 8,408,058 5,708,394

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation and Principles of Consolidation The Company's consolidated financial statements include the results of the financial operations of Clearside Biomedical, Inc. and its wholly-owned subsidiary, Clearside Royalty LLC. a Delaware limited liability company, which was formed for the purposes of the transactions contemplated by the Purchase and Sale Agreement described in Note 5. All intercompany balances and transactions have been eliminated. The Company’s financial statements have been prepared in conformity with accounting principles generally accepted in the United States of America (“U.S. GAAP”).
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and reported amounts of income and expenses during the reporting periods. Significant items subject to such estimates and assumptions include the estimate of the total amount of future royalty revenue and milestone payments to be generated over the life of the Purchase and Sale Agreement, revenue recognition, the accounting for useful lives to calculate depreciation and amortization, clinical trial expense accruals, share-based compensation expense and income tax valuation allowance. Actual results could differ from these estimates.
Revenue Recognition	Revenue Recognition The Company recognizes revenue from its contracts with customers under Financial Accounting Standards Board Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers . The Company’s primary revenue arrangements are license agreements which typically include upfront payments, regulatory and commercial milestone payments and royalties based on future product sales. The arrangements may also include payments for the Company’s SCS Microinjector devices as well as payments for assistance and oversight of the customer’s use of the Company’s technology. In determining the amount of revenue to be recognized under these agreements, the Company performs the following steps: (i) identifies the promised goods and services to be transferred in the contract, (ii) identifies the performance obligations, (iii) determines the transaction price, (iv) allocates the transaction price to the performance obligations and (v) recognizes revenue as the performance obligations are satisfied. The Company receives payments from its customers based on billing schedules established in each contract. Up-front and other payments may require deferral of revenue recognition to a future period until the Company performs its obligations under the arrangement. Amounts are recorded as accounts receivable when the Company’s right to consideration is unconditional. The Company does not assess whether a contract has a significant financing component if the expectation at contract inception is such that the period between payment by the customer and the transfer of the promised goods or services to the customer will be one year or less. In the year ended December 31, 2023, 2022, and 2021, the Company recognized $ 8.2 million, $ 1.3 million, and $ 29.6 million of revenue associated with its license agreements, respectively. License revenue for the year ended December 31, 2023 was primarily for a non-refundable $ 5.0 million upfront license fee payment from BioCryst and $ 1.4 million of milestone payments from Aura Biosciences, Inc. The $ 5.0 million non-refundable upfront payment was recognized upon transfer of control of the license to BioCryst. The $ 1.4 million in milestone payments from Aura were recognized upon satisfaction of the related performance obligations. Remaining revenues for the year ended December 31, 2023 were generated by providing training materials and clinical trial products to the Company's licensees. License revenue for the year ended December 31, 2022 was primarily from providing training materials and clinical trial products to the Company's licensees. License revenue for the year ended December 31, 2021 was primarily a result of (i) the milestone payments from Bausch that consisted of $ 5.0 million received upon FDA approval of XIPERE, the recognition of $ 5.0 million of deferred revenue for the upfront milestone payment and the recognition of a $ 10.0 million milestone for pre-launch activities and (ii) an aggregate of $ 8.0 million received from Arctic Vision for FDA approval of XIPERE, territory expansion and certain development milestones.
Segment Information	Segment Information Operating segments are defined as components of an enterprise about which separate discrete information is available for evaluation by the chief operating decision maker, or decision-making group, in deciding how to allocate resources and in assessing performance. The Company views its operations and manages its business in one operating segment.
Property and Equipment, Net	Property and Equipment, Net Property and equipment is recorded at historical cost. Depreciation is calculated using the straight-line method over the estimated useful lives of the related assets, or for leasehold improvement the lesser of the useful life or remaining lease term. Repairs and maintenance are expensed when incurred. Upon retirement or sale, the cost of the assets disposed of and the related accumulated depreciation are removed from the accounts, and any resulting gain or loss is included in the determination of net income.
Debt Discount	Debt Discount All debt discounts are recorded against the related debt obligation and are amortized using the effective interest rate method over the term of the underlying debt obligation and reflected in interest expense.
Income Taxes	Income Taxes Deferred tax assets or liabilities are recorded for temporary differences between financial statement and tax basis of assets and liabilities, using enacted rates in effect for the year in which the differences are expected to reverse. A valuation allowance is recorded if it is more likely than not that a deferred tax asset will not be realized. The Company has provided a full valuation allowance on its deferred tax assets, which primarily consist of cumulative net operating losses for the period from May 26, 2011 (inception) to December 31, 2023. Due to its history of operating losses since inception and losses expected to be incurred in the foreseeable future, a full valuation allowance was considered necessary. Liabilities for uncertain tax positions are recognized based on a two-step process. The first step is to evaluate the tax position for recognition by determining if the weight of available evidence indicates that it is more likely than not that the position will be sustained on audit, including resolution of related appeals or litigation processes, if any. Once it is determined that the position meets the recognition threshold, the second step requires estimating and measuring the largest amount of tax benefit that is more likely than not to be realized upon ultimate settlement. The difference between the amount of recognizable tax benefit and the total amount of tax benefit from positions filed or to be filed with the tax authorities is recorded as a liability for uncertain tax benefits.
Research and Development Costs	Research and Development Costs Research and development costs are charged to expense as incurred and include: • employee-related expenses, including salaries, benefits, travel and share-based compensation expense for research and development personnel; • expenses incurred under agreements with contract research organizations, contract manufacturing organizations and consultants that conduct preclinical studies and clinical trials; • costs associated with preclinical and clinical development activities; • costs associated with submitting regulatory approval applications for the Company’s product candidates; • costs associated with training physicians on the suprachoroidal injection procedure and educating and providing them with appropriate product candidate information; • costs associated with technology and intellectual property licenses; • costs for the Company’s research and development facility; and • depreciation expense for assets used in research and development activities. Costs for certain development activities, such as clinical trial activities, are recognized based on an evaluation of the estimated total costs for the clinical trial, progress to completion of specific tasks, using data such as patient enrollment, pass through expenses, clinical site activations, data from the clinical sites or information provided to the Company by its vendors on their actual costs incurred. Payments for these activities are based on the terms of the individual contracts and any subsequent amendments, which may differ from the patterns of costs incurred, and are reflected in the financial statements as prepaid or accrued expenses.
Share-Based Compensation	Share-Based Compensation Compensation cost related to share-based awards granted to employees, directors and consultants is measured based on the estimated fair value of the award at the grant date. The fair value of restricted stock units granted is measured based on the market value of the Company’s common stock on the date of grant. Share-based compensation costs are expensed on a straight-line basis over the relevant vesting period. Compensation cost related to shares purchased through the Company’s employee stock purchase plan, which is considered compensatory, is based on the estimated fair value of the shares on the offering date, including consideration of the discount and the look back period. The Company estimates the fair value of the shares using a Black-Scholes option pricing model. Compensation expense is recognized over the six-month withholding period prior to the purchase date. All share-based compensation costs are recorded in general and administrative or research and development costs in the statements of operations based upon the underlying employees’ roles within the Company.
Cash Equivalents	Cash Equivalents Cash equivalents consist of short-term, highly liquid investments with an original term of three months or less at the date of purchase.
Restricted Cash	Restricted Cash The Company is required to maintain a stand-by letter of credit as a security deposit for its facility lease in Alpharetta, Georgia. The Company’s bank requires the Company to maintain a restricted cash balance to serve as collateral for the letter of credit issued to the landlord by the bank. As of December 31, 2022, the restricted cash balance was invested in a commercial money market account. The current portion of the restricted cash is recorded in other current assets and the long-term portion is recorded in restricted cash.
Concentration of Credit Risk Arising From Cash Deposits in Excess of Insured Limits	Concentration of Credit Risk Arising From Cash Deposits in Excess of Insured Limits The Company maintains its cash in bank deposits that at times may exceed federally insured limits. The Company has not experienced any loss in such accounts. The Company believes it is not exposed to any significant risks with respect to its cash balances.
Liability Related to the Sales of Future Royalties and Non-Cash Interest Expense	Liability Related to the Sales of Future Royalties and Non-Cash Interest Expense In connection with the Purchase and Sale Agreement, the Company recognized a liability related to the sales of future royalties under ASC 470-10 Debt and ASC 835-30 Interest - Imputation of Interest. The initial funds received by the Company pursuant to the terms of the Purchase and Sale Agreement were recorded as a liability and are accreted under the effective interest method up to the estimated amount of future royalties and milestone payments to be made under the Purchase and Sale Agreement. The issuance costs were recorded as a direct deduction to the carrying amount of the liability and are being amortized under the effective interest method over the estimated period the liability will be repaid. The Company estimates the total amount of future royalty revenue and milestone payments to be generated over the life of the Purchase and Sale Agreement, and a significant increase or decrease in these estimates could materially impact the liability balance and the related interest expense. If the timing of the receipt of royalty payments or milestones is materially different from the original estimates, the Company will prospectively adjust the effective interest and the related amortization of the liability and related issuance costs.

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	12 Months Ended
	Dec. 31, 2023
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment, Net	Property and equipment, net consisted of the following (dollar amounts in thousands): Estimated December 31, 2023 2022 Furniture and fixtures 5 $ 249 $ 249 Machinery and equipment 5 581 343 Computer equipment 3 20 13 Leasehold improvements Lesser of or 476 476 Work in process 2,590 527 Total property and equipment 3,916 1,608 Less: Accumulated depreciation ( 920 ) ( 853 ) Property and equipment, net $ 2,996 $ 755

Accrued Liabilities (Tables)

Accrued Liabilities (Tables)	12 Months Ended
	Dec. 31, 2023
Payables and Accruals [Abstract]
Schedule of Accrued Liabilities	Accrued liabilities consisted of the following (in thousands): December 31, 2023 2022 Accrued research and development $ 2,078 $ 1,817 Accrued employee costs 1,862 1,837 Accrued professional fees 38 49 Accrued expense 191 476 $ 4,169 $ 4,179

Royalty Purchase and Sale Agr_2

Royalty Purchase and Sale Agreement (Tables)	12 Months Ended
	Dec. 31, 2023
Royalty Purchase and Sales Agreement [Abstract]
Schedule of activity of the royalty obligation	The following table summarizes the activity of the Purchase and Sale Agreement (in thousands): Balance at December 31, 2022 $ 33,977 Payments ( 1,350 ) Non-cash interest expense 9,361 Balance at December 31, 2023 $ 41,988 Effective interest rate 23.3 %

Share-Based Compensation (Table

Share-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2023
Summary of Share-based Compensation Expense	The Company has granted stock option awards to employees, directors and consultants. The total share-based compensation expense recognized is reflected in the statements of operations as follows (in thousands): Year Ended 2023 2022 2021 Research and development $ 1,200 $ 1,616 $ 1,570 General and administrative 1,758 1,785 1,985 Total $ 2,958 $ 3,401 $ 3,555
Weighted Average Assumptions Used in Black-Scholes Option Pricing Model to Calculate Fair Value of Underlying Common Stock	The following table sets forth the weighted average assumptions utilized in the Black-Scholes option pricing model to calculate the fair value of the underlying common stock for the years ended December 31, 2023, 2022 and 2021. Year Ended 2023 2022 2021 Expected term (years) 6.00 6.00 7.00 Expected stock price volatility 95.55 % 98.24 % 101.43 % Risk-free interest rate 4.07 % 2.09 % 0.75 % Expected dividend yield 0.00 % 0.00 % 0.00 %
Summary of Activity Related to Stock Options	The following table summarizes the activity related to stock options during the year ended December 31, 2023: Weighted Number of Average Shares Exercise Price Options outstanding at December 31, 2022 6,915,330 $ 3.58 Granted 3,684,750 1.28 Exercised ( 81,816 ) 0.40 Forfeited or expired ( 652,494 ) 2.32 Options outstanding at December 31, 2023 9,865,770 2.83 Options exercisable at December 31, 2022 4,223,931 4.22 Options exercisable at December 31, 2023 5,494,746 3.83
Additional Information about the Stock Option Outstanding and Exercisable	The following table provides additional information about the Company’s stock options that were outstanding and exercisable at December 31, 2023 (aggregate intrinsic values in thousands): Weighted Weighted Weighted Average Weighted Average Average Aggregate Remaining Average Aggregate Remaining Exercise Options Exercise Intrinsic Contractual Options Exercise Intrinsic Contractual Price Outstanding Price Value Life (Years) Exercisable Price Value Life (Years) $ 0.00 - $ 2.99 6,879,914 7.64 2,836,713 5.73 $ 3.00 - $ 6.99 2,364,770 5.11 2,036,947 4.79 $ 7.00 - $ 8.99 419,308 3.18 419,308 3.18 $ 9.00 - $ 20.84 201,778 3.76 201,778 3.76 9,865,770 $ 2.83 $ 363 6.77 5,494,746 $ 3.83 $ 11 5.12
2016 Employee Stock Purchase Plan
Summary of Share-based Compensation Expense	The share-based compensation expense recognized for the 2016 ESPP is reflected in the statements of operations and comprehensive loss as follows (in thousands): Year Ended 2023 2022 2021 Research and development $ 10 $ 21 $ 41 General and administrative 3 10 20 Total $ 13 $ 31 $ 61
Restricted Stock Units (RSUs)
Summary of Share-based Compensation Expense	The total share-based compensation expense related to RSUs is reflected in the statements of operations as follows (in thousands): Year Ended 2023 2022 2021 Research and development $ 585 $ 794 $ 723 General and administrative 646 658 715 Total $ 1,231 $ 1,452 $ 1,438
Summary of the Activity Related to RSUs	The following table summarizes the activity related to RSUs during the year ended December 31, 2023: Weighted Average Number of Grant Date Shares Fair Value Non-vested RSUs outstanding at December 31, 2022 1,462,932 $ 3.04 Granted — — Vested ( 471,390 ) 3.09 Forfeited ( 156,643 ) 3.09 Non-vested RSUs outstanding at December 31, 2023 834,899 3.01

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Schedule of Net Deferred Tax Assets	Significant components of the Company’s net deferred income tax assets consist of the following (in thousands): December 31, 2023 2022 2021 Deferred tax asset (liability): Net operating loss carryforwards $ 52,657 $ 50,267 $ 53,966 Non-deductible accrued expenses 562 386 469 Right-of-use asset ( 210 ) ( 238 ) ( 96 ) Lease liability 246 274 176 Stock compensation expense 3,339 2,678 2,768 Depreciation differences ( 71 ) ( 40 ) ( 44 ) Federal tax credits 10,908 9,742 9,012 State tax credits 342 326 342 Royalty purchase and sale agreement 10,495 7,247 — Capitalized research and development expenses 5,777 3,057 — Valuation allowance ( 84,045 ) ( 73,699 ) ( 66,599 ) Net deferred tax asset $ — $ — $ ( 6 )
Schedule of Statutory and Effective Income Tax Rate Reconciliation	A reconciliation of the statutory tax rates and the effective tax rates is as follows: Year Ended December 31, 2023 2022 2021 U.S. federal tax rate 21.00 % 21.00 % 21.00 % State tax rate 8.59 ( 0.85 ) ( 599.32 ) Permanent difference ( 1.44 ) ( 1.34 ) ( 3.15 ) Tax credit 3.64 2.18 ( 253.97 ) Valuation allowance ( 31.85 ) ( 21.57 ) 847.82 ASC 740-10 — — ( 3.19 ) Adjustment to prior year tax provision — 0.67 ( 13 ) Other 0.06 ( 0.09 ) 3.97 0.00 % 0.00 % 0.00 %
Summary of Activity Related to Uncertain Tax Positions	The following is a roll forward of the Company’s uncertain tax positions (in thousands): Year Ended December 31, 2023 2022 Balance of uncertain tax positions at the beginning of the year $ 7,520 $ 7,520 Gross decreases - tax positions in prior period — — Gross decreases - settlements with taxing authorities — — Balance of uncertain tax positions at the end of the year $ 7,520 $ 7,520

Commitment and Contingencies (T

Commitment and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Operating Leases Included on the Balance Sheet	The Company’s operating leases included on the balance sheet are as follows (in thousands): December 31, Operating lease right-of-use asset $ 869 Liabilities Current portion of operating lease liabilities $ 364 Operating lease liabilities 649 Total operating lease liabilities $ 1,013
Future Minimum Commitments Due Under Non-Cancelable Operating Leases	Minimum lease payments were as follows at December 31, 2023 (in thousands): Year ending December 31, 2024 $ 378 2025 389 2026 367 Total minimum lease payments 1,134 Less imputed interest ( 121 ) Total operating lease liabilities $ 1,013
Schedule of Annual Maintenance Fee Payments	The annual Maintenance Fee will be paid as follows (in thousands): Year Ending December 31, 2024 $ 250 2025 250 2026 350 2027 400 2028 500 $ 1,750

Net Income (Loss) Per Share (Ta

Net Income (Loss) Per Share (Tables)	12 Months Ended
	Dec. 31, 2023
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	Therefore, the denominator used to calculate both basic and diluted net loss per share is the same in all periods presented. Year Ended December 31, 2023 2022 2021 Net (loss) income - basic and diluted $ ( 32,485 ) $ ( 32,947 ) $ 376 Weighted average shares - basic 61,806,959 60,204,862 58,491,986 Effect of dilutive securities: Stock options — — 1,058,134 Restricted stock — — 342,943 ESPP — — 13,539 Weighted average shares - diluted 61,806,959 60,204,862 59,906,602 Net (loss) income per share - basic $ ( 0.53 ) $ ( 0.55 ) $ 0.01 Net (loss) income per share - diluted $ ( 0.53 ) $ ( 0.55 ) $ 0.01
Potential Common Stock Equivalents Excluded from Computation of Diluted Net Loss per Share	The Company’s potential common stock equivalents that have been excluded from the computation of diluted net income (loss) per share for all periods presented because of their antidilutive effect consisted of the following: Year Ended 2023 2022 2021 Outstanding stock options 9,865,770 6,915,330 4,704,194 Non-vested restricted stock units 834,899 1,462,932 974,404 Stock purchase warrants 29,796 29,796 29,796 10,730,465 8,408,058 5,708,394

The Company - Additional Inform

The Company - Additional Information (Details) - USD ($)

1 Months Ended

6 Months Ended

12 Months Ended

Feb. 06, 2024

Nov. 01, 2023

Aug. 08, 2022

Jan. 06, 2021

Feb. 06, 2024

Jan. 31, 2022

Jun. 30, 2023

Dec. 31, 2023

Dec. 31, 2022

Dec. 31, 2021

May 31, 2023

Sep. 30, 2021

Sep. 30, 2016

Entity incorporation date

May 26, 2011

Cash and cash equivalents

$ 28,920,000

$ 48,258,000

$ 30,436,000

Initial payment

32,100,000

Initial proceeds from royalty purchase and sale agreement

33,977,000

32,500,000

Proceeds from royalty purchase and sale agreement

0

(30,638,000)

$ 0

Maintenance Fee Due 2023

250,000

Maintenance Fee Due 2024

250,000

Maintenance Fee Due 2025

250,000

Maintenance Fee Due 2026

350,000

Maintenance Fee Due 2027

400,000

Maintenance Fee Due 2028

$ 500,000

Proceeds from registered direct offering

$ 13,900,000

Royalty Purchase And Sale Agreement

Royalty purchased

1,500,000

Proceeds from royalty purchase and sale agreement

$ 30,600,000

License Arrangement

Minimum Sales To Applied Highest Royalty Rate

$ 1,500,000,000

Upfront License Fee

5,000,000

Clinical And Regulatory Milestone Payments

30,000,000

Sales-Based Milestone Payments

47,500,000

Global Net Product Sales Milestones

$ 2,000,000,000

Letter Agreement

Milestone payments

$ 12,500,000

Arctic Vision Limited | License Arrangement

Consideration received from expansion of business

$ 3,000,000

Bausch Health Ireland Limited

Aggregate milestone payments from the licensees

$ 10,000,000

Common Stock [Member]

Number of shares sold under facility

11,111,111

Common Stock Warrants [Member]

Class of warrant Exercise

$ 10.74

Purchase price of share and warrant

$ 1.35

$ 1.35

Warrant [Member]

Class of warrant Exercise

$ 1.62

$ 1.62

Warrant exercisable date

Aug. 09, 2024

Warrant expiration date

Aug. 09, 2029

Maximum [Member]

Number of stock that can be purchased by each warrant

29,796

Maximum [Member] | Common Stock [Member]

Number of shares sold under facility

11,111,111

Maximum [Member] | Warrant [Member]

Number of stock that can be purchased by each warrant

11,111,111

11,111,111

Cowen and Company LLC | Subsequent Event

Number of shares sold under facility

339,912

Cantor Fitzgerald Co. | In May 2023

Number of shares sold under facility

2.9

Cantor Fitzgerald Co. | Subsequent Event

Net proceeds from issuance of stock

$ 500,000

$ 500,000

Private Placement

Purchase of common stock by institutional purchasers

4,200,000

Purchase price per share

$ 2.851

Net proceeds after deducting offering expenses

$ 11,100,000

At-the-market Sales Agreement | Cowen and Company LLC

Number of shares sold under facility

515,959

425,460

Net proceeds from issuance of stock

$ 700,000

At-the-market Sales Agreement | Cantor Fitzgerald Co.

Net proceeds from issuance of stock

$ 12,200,000

At-the-market Sales Agreement | Cantor Fitzgerald Co. | In May 2023

Number of shares sold under facility

1,073,740

Net proceeds from issuance of stock

$ 600,000

Common stock shares aggregate offering price

$ 50,000,000

Sales Agreement [Member] | Cantor Fitzgerald Co.

Net proceeds from issuance of stock

$ 1,100,000

Significant Accounting Polici_3

Significant Accounting Policies - Additional Information (Detail) $ in Thousands		12 Months Ended
	Oct. 22, 2019 USD ($)	Dec. 31, 2023 USD ($) NumberOfSegment	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Oct. 31, 2021 USD ($)
Number of operating segments | NumberOfSegment		1
Revenue		$ 8,226	$ 1,327	$ 29,575
Deferred revenue		75	205
Bausch
Milestone Payments Received				5,000
Upfront payment	$ 5,000
Pre-launch milestone payments				10,000
Bausch | Upfront Payment
Deferred revenue				5,000	$ 5,000
BioCryst
Upfront payment		5,000
Aura
Milestone Payments Received		1,400
License [Member]
Revenue		$ 8,200	$ 1,300	29,600
License [Member] | Arctic Vision Limited
Consideration received for territory expansion				$ 8,000

Property and Equipment, Net - S

Property and Equipment, Net - Schedule of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Property Plant And Equipment [Line Items]
Total property and equipment	$ 3,916	$ 1,608
Less: Accumulated depreciation	(920)	(853)
Property and equipment, net	2,996	755
Furniture and Fixtures
Property Plant And Equipment [Line Items]
Total property and equipment	$ 249	249
Estimated Useful Lives (Years)	5 years
Machinery and Equipment
Property Plant And Equipment [Line Items]
Total property and equipment	$ 581	343
Estimated Useful Lives (Years)	5 years
Computer Equipment
Property Plant And Equipment [Line Items]
Total property and equipment	$ 20	13
Estimated Useful Lives (Years)	3 years
Leasehold Improvements
Property Plant And Equipment [Line Items]
Total property and equipment	$ 476	476
Property, Plant, and Equipment, Useful Life, Term, Description [Extensible Enumeration]	us-gaap:UsefulLifeTermOfLeaseMember
Work in process
Property Plant And Equipment [Line Items]
Total property and equipment	$ 2,590	$ 527

Accrued Liabilities - Schedule

Accrued Liabilities - Schedule of Accrued Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Accrued research and development	$ 2,078	$ 1,817
Accrued employee costs	1,862	1,837
Accrued professional fees	38	49
Accrued expense	191	476
Accrued liabilities, current	$ 4,169	$ 4,179

Royalty Purchase and Sale Agr_3

Royalty Purchase and Sale Agreement (Additional Information) (Details) - USD ($) $ in Thousands		12 Months Ended
	Aug. 08, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Research and Development Arrangement, Contract to Perform for Others [Line Items]
Initial proceeds from royalty purchase and sales agreement			$ 32,500
Purchase and sale agreement description		The Purchase and Sale Agreement will automatically expire, and the payment of Royalties from the Royalty Sub to HCR will cease, when HCR has received payments of the Royalties equal to 2.5 times the aggregate amount of payments made by HCR under the Agreement if the Second Milestone Event is achieved on or prior to December 31, 2024 (the “Initial Cap”). If the Second Milestone Event is not achieved on or prior to December 31, 2024, payment of Royalties from Royalty Sub to HCR will cease when HCR has received Royalties payments equal to 3.4 times the aggregate amount of payments under the Purchase and Sale Agreement (the “Alternative Cap”, and together with the Initial Cap, the “Cap Amount”). In the event of a change in control, acquiror will have the option to make a payment to HCR of the Cap Amount then in effect, less the aggregate amount of Royalty payments made by Royalty Sub to HCR under the Purchase and Sale Agreement as a one-time payment at which time, payment of Royalties to HCR will cease. Alternatively, in the event of a change in control, the acquiror will have the option to make an initial payment of 1.0 times the aggregate amount of payments made by HCR under the Purchase and Sale Agreement as of the date of such change in control, then in that event, payment of Royalties from Royalty Sub to HCR will cease when HCR has received total Royalties payments (including the initial payment) equal to the Alternative Cap. After the Purchase and Sale Agreement expires, all rights to receive the Royalties return to Royalty Sub.On December 22, 2023, the Company, through its wholly owned subsidiary Royalty Sub, entered into the Letter Agreement with the Agent amending that certain Purchase and Sale Agreement, dated as of August 8, 2022, by and among Royalty Sub, HCR and Agent. Pursuant to the terms of the Letter Agreement, Royalty Sub and Agent mutually agreed that Royalty Sub waived any and all rights to the First Milestone Payment in connection with the closing of the transactions contemplated by the Purchase and Sale Agreement and agreed to the release of the First Milestone Payment to Agent.
Debt related commitment fees and debt related issuance costs			1,900
Proceeds from royalty purchase and sale agreement, net of issuance costs		$ 0	(30,638)	$ 0
Royalty Purchase and Sale Agreement [Member]
Research and Development Arrangement, Contract to Perform for Others [Line Items]
Payments on royalty purchase and sale agreement			1,500
Proceeds from royalty purchase and sale agreement, net of issuance costs			$ 30,600
Royalty Purchase and Sale Agreement [Member] | Royalty Sub Member [Member]
Research and Development Arrangement, Contract to Perform for Others [Line Items]
Initial proceeds from royalty purchase and sales agreement net of certain expenses	$ 32,100
First Milestone Proceeds From Royalty Purchase And Sale Agreement	12,500
Second Milestone Proceeds From Royalty Purchase And Sale Agreement	20,000
Royalty Purchase and Sale Agreement [Member] | Royalty Sub Member [Member] | Maximum [Member]
Research and Development Arrangement, Contract to Perform for Others [Line Items]
Maximum proceeds from royalty purchase and sale agreement	$ 65,000

Royalty Purchase and Sale Agr_4

Royalty Purchase and Sale Agreement - Schedule of activity of the royalty obligation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Royalty Obligation [Abstract]
Balance at December 31, 2022	$ 33,977	$ 32,500
Payments on royalty purchase and sale agreement	(1,350)	0	$ 0
Non-cash interest expense	9,361	3,339	$ 0
Balance at December 31, 2023	$ 41,988	$ 33,977
Effective interest rate	23.30%

CARES Act Paycheck Protection_2

CARES Act Paycheck Protection Program Loan - Additional Information (Details) - PPP Loan - USD ($)		1 Months Ended
	Jan. 11, 2021	Apr. 20, 2020
Short Term Debt [Line Items]
Interest expense on borrowings	$ 7,000
Silicon Valley Bank
Short Term Debt [Line Items]
Aggregate principal amount		$ 1,000,000
Interest rate on outstanding principal amount		1%
Note, Maturity date		Apr. 30, 2022

Preferred and Common Stock - Ad

Preferred and Common Stock - Additional Information (Detail) - $ / shares	Dec. 31, 2023	Dec. 31, 2022	Jun. 22, 2022
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, shares authorized	200,000,000	200,000,000	100,000,000
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares outstanding	62,850,841	60,639,827
Maximum [Member]
Common stock, shares authorized			200,000,000

Common Stock Warrants - Additio

Common Stock Warrants - Additional Information (Details) - $ / shares		1 Months Ended	12 Months Ended
	Feb. 06, 2024	Sep. 30, 2016	Dec. 31, 2023
Class Of Warrant Or Right [Line Items]
Weighted average remaining life of warrants			2 years 9 months
Maximum [Member]
Class Of Warrant Or Right [Line Items]
Number of stock that can be purchased by each warrant		29,796
Convertible Stock Warrant
Class Of Warrant Or Right [Line Items]
Class of warrant Exercise		$ 10.74
Purchase price of share and warrant	$ 1.35
Warrants expiration term		2026-09
Common Stock
Class Of Warrant Or Right [Line Items]
Number of shares sold under facility	11,111,111
Common Stock | Maximum [Member]
Class Of Warrant Or Right [Line Items]
Number of shares sold under facility	11,111,111
Warrant [Member]
Class Of Warrant Or Right [Line Items]
Class of warrant Exercise	$ 1.62
Warrant exercisable date	Aug. 09, 2024
Warrant expiration date	Aug. 09, 2029
Warrant [Member] | Maximum [Member]
Class Of Warrant Or Right [Line Items]
Number of stock that can be purchased by each warrant	11,111,111

Share-Based Compensation - Addi

Share-Based Compensation - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions			12 Months Ended
	Jan. 01, 2024	Jan. 31, 2016	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
2016 Stock Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Annual increase of common stock reserved for issuance	4%
Increase in common stock for future issuance, shares	2,514,033
Shares common stock reserved for issuance	3,084,057
2016 Employee Stock Purchase Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share based compensation arrangement description			The number of shares reserved for issuance under the 2016 ESPP will automatically increase on January 1 of each year, through January 1, 2026, by the lesser of (i) 1% of the total number of shares of the Company’s common stock outstanding on December 31 of the preceding calendar year, (ii) 454,545 shares of common stock or (iii) a lesser number of shares as may be determined by the Company’s board of directors
Shares common stock reserved for issuance			348,782
Employee payroll deductions, percent		15%
Addition of common stock shares reserved for future issuance		454,545
Issuance of common shares under employee stock purchase plan, shares			68,109	66,919	65,481
Stock Options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Option to purchase common stock shares outstanding			9,865,770
Weighted average exercise price			$ 3.83
Unrecognized compensation expense related to unvested stock options			$ 4.1
Expected to be recognized over a weighted average period			2 years 3 months 18 days
Weighted-average fair values granted			$ 0.98	$ 1.55	$ 3.24
Fair market value per share of common stock			$ 1.17
Stock Options | 2016 Stock Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Share based compensation arrangement description			The number of shares of common stock reserved for issuance under the 2016 Plan will automatically increase on January 1 each year, through January 1, 2026, by 4% of the total number of shares of the Company’s common stock outstanding on December 31 of the preceding calendar year, or a lesser number of shares as may be determined by the Company’s board of directors.
Annual increase of common stock reserved for issuance			4%
Option to purchase common stock shares outstanding			9,638,424
Weighted average exercise price			$ 2.79
Shares available for future grant			570,024
Stock Options | 2011 Stock Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares grants			0
Option to purchase common stock shares outstanding			210,110
Weighted average exercise price			$ 4.28
Restricted Stock Units (RSUs)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected to be recognized over a weighted average period			1 year 6 months
Unrecognized compensation expense related to the RSUs			$ 1.3

Share-Based Compensation - Summ

Share-Based Compensation - Summary of Share-based Compensation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
2016 Employee Stock Purchase Plan
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Share-based compensation expense	$ 13	$ 31	$ 61
2016 Employee Stock Purchase Plan | Research and Development
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Share-based compensation expense	10	21	41
2016 Employee Stock Purchase Plan | General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Share-based compensation expense	3	10	20
Stock Options | 2016 Equity Incentive Plan
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Share-based compensation expense	2,958	3,401	3,555
Stock Options | 2016 Equity Incentive Plan | Research and Development
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Share-based compensation expense	1,200	1,616	1,570
Stock Options | 2016 Equity Incentive Plan | General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Share-based compensation expense	1,758	1,785	1,985
Restricted Stock Units (RSUs)
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Share-based compensation expense	1,231	1,452	1,438
Restricted Stock Units (RSUs) | Research and Development
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Share-based compensation expense	585	794	723
Restricted Stock Units (RSUs) | General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Share-based compensation expense	$ 646	$ 658	$ 715

Share-Based Compensation - Weig

Share-Based Compensation - Weighted Average Assumptions Used in Black-Scholes Option Pricing Model to Calculate Fair Value of Underlying Common Stock (Details) - Stock Options	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Expected term (years)	6 years	6 years	7 years
Expected stock price volatility	95.55%	98.24%	101.43%
Risk-free interest rate	4.07%	2.09%	0.75%
Expected dividend yield	0%	0%	0%

Share-Based Compensation - Su_2

Share-Based Compensation - Summary of Activity Related to Stock Options (Details) - Stock Options - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of Shares, Options outstanding, Ending balance	9,865,770
Number of Shares, Options exercisable	5,494,746
Weighted Average Exercise Price, Options outstanding, Ending balance	$ 3.83
Weighted Average Exercise Price, Options exercisable	$ 2.83
2011 Stock Incentive Plan, 2016 Equity Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of Shares, Options outstanding, Beginning balance	6,915,330
Number of Shares, Granted	3,684,750
Number of Shares, Exercised	(81,816)
Number of Shares, Cancelled/Forfeited	(652,494)
Number of Shares, Options outstanding, Ending balance	9,865,770	6,915,330
Number of Shares, Options exercisable	5,494,746	4,223,931
Weighted Average Exercise Price, Options outstanding, Beginning balance	$ 3.58
Weighted Average Exercise Price, Granted	1.28
Weighted Average Exercise Price, Exercised	0.4
Weighted Average Exercise Price, Cancelled/Forfeited	2.32
Weighted Average Exercise Price, Options outstanding, Ending balance	2.83	$ 3.58
Weighted Average Exercise Price, Options exercisable	$ 3.83	$ 4.22

Share-Based Compensation - Ad_2

Share-Based Compensation - Additional Information about the Stock Option Outstanding and Exercisable (Details) - Stock Options $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) $ / shares shares
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Options Outstanding | shares	9,865,770
Weighted Average Exercise Price | $ / shares	$ 3.83
Aggregate Intrinsic Value | $	$ 363
Weighted Average Remaining Contractual Life (Years)	6 years 9 months 7 days
Options Exercisable | shares	5,494,746
Weighted Average Exercise Price | $ / shares	$ 2.83
Aggregate Intrinsic Value | $	$ 11
Weighted Average Remaining Contractual Life (Years)	5 years 1 month 13 days
$0.00 - $2.99
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise Price Lower Range Limit | $ / shares	$ 0
Exercise Price Upper Range Limit | $ / shares	$ 2.99
Options Outstanding | shares	6,879,914
Weighted Average Remaining Contractual Life (Years)	7 years 7 months 20 days
Options Exercisable | shares	2,836,713
Weighted Average Remaining Contractual Life (Years)	5 years 8 months 23 days
$3.00 - $6.99
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise Price Lower Range Limit | $ / shares	$ 3
Exercise Price Upper Range Limit | $ / shares	$ 6.99
Options Outstanding | shares	2,364,770
Weighted Average Remaining Contractual Life (Years)	5 years 1 month 9 days
Options Exercisable | shares	2,036,947
Weighted Average Remaining Contractual Life (Years)	4 years 9 months 14 days
$7.00 - $8.99
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise Price Lower Range Limit | $ / shares	$ 7
Exercise Price Upper Range Limit | $ / shares	$ 8.99
Options Outstanding | shares	419,308
Weighted Average Remaining Contractual Life (Years)	3 years 2 months 4 days
Options Exercisable | shares	419,308
Weighted Average Remaining Contractual Life (Years)	3 years 2 months 4 days
$9.00 - $20.84
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise Price Lower Range Limit | $ / shares	$ 9
Exercise Price Upper Range Limit | $ / shares	$ 20.84
Options Outstanding | shares	201,778
Weighted Average Remaining Contractual Life (Years)	3 years 9 months 3 days
Options Exercisable | shares	201,778
Weighted Average Remaining Contractual Life (Years)	3 years 9 months 3 days

Share-Based Compensation - Su_3

Share-Based Compensation - Summary of the Activity Related to RSUs (Details) - Restricted Stock Units (RSUs)	12 Months Ended
	Dec. 31, 2023 $ / shares shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Non-vested units outstanding, Number of Shares, Beginning balance | shares	1,462,932
Number of Shares, Granted | shares	0
Number of Shares, Vested | shares	(471,390)
Number of Shares, Forfeited | shares	(156,643)
Non-vested units outstanding, Number of Shares, Ending balance | shares	834,899
Non-vested units outstanding, Weighted Average Grant Date Fair Value, Beginning balance | $ / shares	$ 3.04
Weighted Average Grant Date Fair Value, Granted | $ / shares	0
Weighted Average Grant Date Fair Value, Vested | $ / shares	3.09
Weighted Average Grant Date Fair Value, Forfeited | $ / shares	3.09
Non-vested units outstanding, Weighted Average Grant Date Fair Value, Ending balance | $ / shares	$ 3.01

Income Taxes - Schedule of Net

Income Taxes - Schedule of Net Deferred Tax Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Deferred tax asset (liability)
Net operating loss carryforwards	$ 52,657	$ 50,267	$ 53,966
Non-deductible accrued expenses	562	386	469
Right-of-use asset	(210)	(238)	(96)
Lease liability	246	274	176
Stock compensation expense	3,339	2,678	2,768
Depreciation differences	(71)	(40)	(44)
Royalty Purchases And Sale Agreement	10,495	7,247	0
Capitalized research and development expenses	5,777	3,057	0
Valuation allowance	(84,045)	(73,699)	(66,599)
Net deferred tax asset	0	0	(6)
Federal
Deferred tax asset (liability)
Net operating loss carryforwards	47,400
Tax credits	10,908	9,742	9,012
State
Deferred tax asset (liability)
Net operating loss carryforwards	5,600
Tax credits	$ 342	$ 326	$ 342

Income Taxes - Schedule of Stat

Income Taxes - Schedule of Statutory and Effective Income Tax Rate Reconciliation (Detail)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
U.S. federal tax rate	21%	21%	21%
State tax rate	8.59%	(0.85%)	(599.32%)
Permanent difference	(1.44%)	(1.34%)	(3.15%)
Tax credit	3.64%	2.18%	(253.97%)
Valuation allowance	(31.85%)	(21.57%)	847.82%
ASC 740-10	0%	0%	(3.19%)
Adjustment to prior year tax provision	0%	0.67%	(13.00%)
Other	0.06%	(0.09%)	3.97%
Total income tax provision (benefit)	0%	0%	0%

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2021	Dec. 31, 2022
Income Tax Disclosure [Line Items]
Deferred tax assets, valuation allowance	$ 84,045,000	$ 66,599,000	$ 73,699,000
Deferred tax assets, net operating loss carryforwards	52,657,000	53,966,000	50,267,000
Unrecognized tax benefits that would affect the effective tax rate if recognized	7,500,000		$ 7,500,000
Unrecognized tax expenses		$ 48,000
Unrecognized tax benefits, income tax penalties expense	$ 0
Operating loss carryforwards, limitations on use	Ownership changes, as defined by Section 382 of the Internal Revenue Code of 1986, as amended (the “Code”), may limit the amount of net operating losses that a company may utilize to offset future taxable income and taxes payable. In general, if the Company experiences a greater than 50% aggregate change in ownership over a 3-year period (a Section 382 ownership change), utilization of the Company’s pre-change NOL carryforwards may be subject to limitation under the Code. The annual limitation generally is determined by multiplying the value of the Company’s stock at the time of such ownership change (subject to certain adjustments) by the applicable long-term tax-exempt rate for the month in which the ownership change occurred. Such limitation may result in expiration of a portion of the NOL carryforwards before utilization. The Company has completed an owner shift analysis to determine the dates in which the Company may have experienced a Section 382 ownership change, and determined that the Company experienced ownership changes for Section 382 purposes in January 2012, December 2013, and July 2016.
Deferred tax Federal Net Operating Carry forward	$ 38,000
Deferred tax Federal Research and Development credit	2,000
Federal
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	225,900,000
Deferred tax assets, net operating loss carryforwards	$ 47,400,000
Federal | Earliest Tax Year
Income Tax Disclosure [Line Items]
Operating loss carryforwards expiration period	2034
State
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	$ 89,300,000
Deferred tax assets, net operating loss carryforwards	$ 5,600,000
State | Earliest Tax Year
Income Tax Disclosure [Line Items]
Operating loss carryforwards expiration period	2027

Income Taxes - Summary of Activ

Income Taxes - Summary of Activity Related to Uncertain Tax Positions (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Summary of activity related to uncertain tax positions
Balance of uncertain tax positions at the beginning of the year	$ 7,520	$ 7,520
Gross decreases - tax positions in prior period	0	0
Gross decreases - settlements with taxing authorities	0	0
Balance of uncertain tax positions at the end of the year	$ 7,520	$ 7,520

Commitment and Contingencies -

Commitment and Contingencies - Additional Information (Details)	1 Months Ended		12 Months Ended
	Nov. 30, 2022 USD ($) ft²	May 31, 2018	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Commitment And Contingencies [Line Items]
Lessee, operating lease, option to extend, description			The renewal option is not included in the calculation of the right-of-use asset and the lease liabilities as the Company is not reasonably certain if the Alpharetta, Georgia lease will be renewed.
Incremental borrowing rate			8%
Operating lease, remaining lease term			3 years
Operating Lease, Cost			$ 339,000	$ 262,000	$ 247,000
Variable Lease, Cost			19,000	87,000	95,000
Short-term Lease, Cost			93,000	86,000	12,000
Operating lease liabilities			$ 362,000	$ 339,000	$ 392,000
Manufacturing Supply Agreement | Gerresheimer Regensburg GmbH
Commitment And Contingencies [Line Items]
Initial term of agreement		5 years
Renewal term of agreement		3 years
GEORGIA
Commitment And Contingencies [Line Items]
Area of office leased | ft²	14,000
Operating lease agreement term	4 years
Operating lease agreement renewal option term	38 months
Minimum monthly lease payments	$ 30,437
Percentage of increase per year	3%

Commitment and Contingencies _2

Commitment and Contingencies - Operating Leases Included on the Balance Sheet (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Operating lease right-of-use asset	$ 869	$ 1,117
Liabilities
Current portion of operating lease liabilities	364	349
Operating lease liabilities	649	$ 936
Total operating lease liabilities	$ 1,013

Commitment and Contingencies _3

Commitment and Contingencies - Future Minimum Commitments Due Under Non-Cancelable Operating Leases (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Commitments and Contingencies Disclosure [Abstract]
2024	$ 378
2025	389
2026	367
Total minimum lease payments	1,134
Less imputed interest	(121)
Total operating lease liabilities	$ 1,013

Commitments and Contingencies -

Commitments and Contingencies - Summary of Annual Maintenance Fee Payments (Details)	Dec. 31, 2023 USD ($)
Commitments and Contingencies Disclosure [Abstract]
2024	$ 250,000
2025	250,000
2026	350,000
2027	400,000
2028	500,000
Total	$ 1,750,000

License and Other Agreements -

License and Other Agreements - Additional Information (Detail) - USD ($)

1 Months Ended

3 Months Ended

12 Months Ended

Jan. 01, 2024

Nov. 01, 2023

Aug. 08, 2022

Mar. 10, 2020

Oct. 22, 2019

Dec. 31, 2021

Sep. 30, 2021

Sep. 30, 2020

Oct. 31, 2019

Dec. 31, 2021

Dec. 31, 2023

Dec. 31, 2022

Dec. 31, 2021

Oct. 31, 2021

Research And Development Arrangement Contract To Perform For Others [Line Items]

Deferred revenue

$ 75,000

$ 205,000

Revenue

8,226,000

1,327,000

$ 29,575,000

Maintenance Fee Due 2023

250,000

Maintenance Fee Due 2024

250,000

Maintenance Fee Due 2025

250,000

Maintenance Fee Due 2026

350,000

Maintenance Fee Due 2027

400,000

Maintenance Fee Due 2028

500,000

Other Agreement

Research And Development Arrangement Contract To Perform For Others [Line Items]

Revenue

50,000

$ 13,000

200,000

Letter Agreement [Member]

Research And Development Arrangement Contract To Perform For Others [Line Items]

Milestone payments

$ 12,500,000

License Arrangement

Research And Development Arrangement Contract To Perform For Others [Line Items]

Sales-based milestone payments

$ 47,500,000

License Arrangement | REGENXBIO, Inc.

Research And Development Arrangement Contract To Perform For Others [Line Items]

Option fee paid

$ 2,000,000

Proceeds from option fee previously received

500,000

Milestone payments

31,000,000

Sales-based milestone payments

$ 102,000,000

Milestone payments received

$ 3,000,000

Bausch Health Ireland Limited

Research And Development Arrangement Contract To Perform For Others [Line Items]

Upfront payment

$ 5,000,000

Pre-launch milestone payments

10,000,000

Milestone payments received

5,000,000

Bausch Health Ireland Limited | Upfront Payment

Research And Development Arrangement Contract To Perform For Others [Line Items]

Deferred revenue

$ 5,000,000

$ 5,000,000

5,000,000

$ 5,000,000

Bausch Health Ireland Limited | XIPERE [Member]

Research And Development Arrangement Contract To Perform For Others [Line Items]

Pre-launch milestone payments

$ 10,000,000

First cumulative net sales of products

45,000,000

Revenue

$ 5,000,000

Bausch Health Ireland Limited | XIPERE [Member] | Maximum [Member]

Research And Development Arrangement Contract To Perform For Others [Line Items]

Additional milestone payments

$ 55,000,000

Arctic Vision Limited | Maximum [Member]

Research And Development Arrangement Contract To Perform For Others [Line Items]

Threshold percentage of sales for tiered royalties

12%

Arctic Vision Limited | Minimum [Member]

Research And Development Arrangement Contract To Perform For Others [Line Items]

Threshold percentage of sales for tiered royalties

10%

Arctic Vision Limited | License Arrangement

Research And Development Arrangement Contract To Perform For Others [Line Items]

Consideration received for territory expansion

$ 3,000,000

Arctic Vision Limited | License Arrangement | Upfront Payment

Research And Development Arrangement Contract To Perform For Others [Line Items]

Upfront payment

$ 4,000,000

Arctic Vision Limited | License Arrangement | Maximum [Member]

Research And Development Arrangement Contract To Perform For Others [Line Items]

Development milestone payments

$ 22,500,000

Arctic Vision Limited | XIPERE [Member]

Research And Development Arrangement Contract To Perform For Others [Line Items]

Milestone payments

$ 4,000,000

BioCryst Pharmaceuticals, Inc [Member]

Research And Development Arrangement Contract To Perform For Others [Line Items]

Upfront payment

$ 5,000,000

BioCryst Pharmaceuticals, Inc [Member] | License Arrangement

Research And Development Arrangement Contract To Perform For Others [Line Items]

Sales-based milestone payments

47,500,000

Global sales amount

1,500,000,000

BioCryst Pharmaceuticals, Inc [Member] | License Arrangement | Upfront Payment

Research And Development Arrangement Contract To Perform For Others [Line Items]

Upfront payment

5,000,000

BioCryst Pharmaceuticals, Inc [Member] | License Arrangement | Maximum [Member]

Research And Development Arrangement Contract To Perform For Others [Line Items]

Sales-based milestone payments

$ 2,000,000,000

BioCryst Pharmaceuticals, Inc [Member] | XIPERE [Member]

Research And Development Arrangement Contract To Perform For Others [Line Items]

Milestone payments

$ 30,000,000

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Details) - USD ($)	Dec. 31, 2023	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Significant transfers between Levels 1, 2 and 3	$ 0	$ 0

Related Party Transactions (Det

Related Party Transactions (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Related Party Transaction [Line Items]
Accounts payable current related party	$ 331,000
Accrued liabilities to a related party	215,000
Accrued Expense	4,169,000	$ 4,179,000
License and other revenue from Related Party	5,050,000
Chief Executive Officer [Member]
Related Party Transaction [Line Items]
Accounts payable current related party	331,000
Accrued liabilities to a related party	215,000
Research and development to Realted Party	1,100,000
Board of Directors [Member]
Related Party Transaction [Line Items]
License and other revenue from Related Party	$ 5,000,000

Net Income (Loss) Per Share - S

Net Income (Loss) Per Share - Schedule of Earnings Per Share, Basic and Diluted (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Net income (loss) - basic and diluted	$ (32,485)	$ (32,947)	$ 376
Weighted average shares - basic	61,806,959	60,204,862	58,491,986
Effect of dilutive securities:
Weighted average shares outstanding - diluted	61,806,959	60,204,862	59,906,602
Net (loss) income per share of common stock - basic	$ (0.53)	$ (0.55)	$ 0.01
Net (loss) income per share of common stock - diluted	$ (0.53)	$ (0.55)	$ 0.01
Stock Options [Member]
Effect of dilutive securities:
Weighted Average Number of Shares Outstanding, Diluted, Adjustment	0	0	1,058,134
Restricted Stock [Member]
Effect of dilutive securities:
Weighted Average Number of Shares Outstanding, Diluted, Adjustment	0	0	342,943
ESPP [Member]
Effect of dilutive securities:
Weighted Average Number of Shares Outstanding, Diluted, Adjustment	0	0	13,539

Net Loss Per Share - Potential

Net Loss Per Share - Potential Common Stock Equivalents Excluded from Computation of Diluted Net Loss per Share (Details) - shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share	10,730,465	8,408,058	5,708,394
Outstanding Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share	9,865,770	6,915,330	4,704,194
Non-vested Restricted Stock Units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share	834,899	1,462,932	974,404
Stock Purchase Warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share	29,796	29,796	29,796