EFFECTS OF FARICIMAB LOADING PHASE ON DIABETIC MACULAR EDEMA IN REAL-WORLD SETTING: An Optical Coherence Tomography...

Area of Science:

• Ophthalmology
• Retinal Diseases
• Pharmacology

Background:

• Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
• Resistant DME often requires alternative treatment strategies beyond standard therapies.
• Intravitreal faricimab is an investigational bispecific antibody targeting angiopoietins and VEGF.

Purpose of the Study:

• To evaluate the functional and anatomic outcomes of intravitreal faricimab in eyes with resistant DME.
• To assess the efficacy of a four-injection loading phase of faricimab.

Main Methods:

• Prospective study of 46 eyes with previously treated resistant DME.
• Monthly assessments included best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and angiography.
• Key biomarkers: central macular thickness (CMT), ellipsoid zone/external limiting membrane integrity, hyperreflective foci, inner retinal layer disorganization, epiretinal membrane, subretinal fluid, and retinal vessel density (VD).

Main Results:

• Significant BCVA improvement from baseline to 4 months (P=0.03).
• Anatomic improvement observed in 91% of eyes, with a mean CMT reduction of 108.4 µm (P=0.0002).
• Reduction in hyperreflective foci (P=0.0005) and improvement in inner retinal layer disorganization were noted. Parafoveal deep capillary plexus VD increased (P=0.04).

Conclusions:

• The loading phase of intravitreal faricimab demonstrated promising visual and structural improvements in resistant DME.
• Faricimab offers a potential new therapeutic option for patients with challenging DME cases.
• Further research is warranted to confirm long-term efficacy and safety.