糖尿病黄斑浮腫に対するファリシマブ負荷期におけるベースライングリコ化ヘモグロビン値と機能的および解剖学的転帰との関連

To evaluate whether baseline glycosylate hemoglobin (HbA1C) levels play a predictive role in faricimab loading phase outcomes. Additionally, we assessed the efficacy of faricimab loading phase for diabetic macular edema (DME).

We conducted a retrospective, multicentric, interventional cohort study including 74 eyes, presenting with a central macular thickness (CMT) > 280 µm, visual acuity (VA) > 20/200, and OCT-based diagnosis of DME.

A statistically significant negative correlation was found between baseline HbA1c and the change in VA following intravitreal faricimab injections (ρ = -0.32, p = 0.006) ). In multivariable regression this association was not significant (β ≈ -0.026 logMAR per 1% HbA1c; p=0.26; ≈ +1.3 letters/1%). The correlation between baseline HbA1c and the change in CMT was not statistically significant (ρ = +0.13, p = 0.279). VA improved significantly from baseline to post-treatment ((-0.18± 0.22 Δ LogMAR ;p < 0.0001). Mean baseline CMT (440.4 ± 152.9 micron) significantly decreased (310.9 ± 87.8 micron, p < 0.0001). We observed a significant reduction of hyperreflective foci(p < 0.0001) and intraretinal fluid (IRF) (p = 0.0014), and the subretinal fluid (SRF) decreased from 29.7% to 10.8% after treatment (p = 0.023).

Systemic glycemic status may influence functional outcomes, supporting the importance of maintaining optimal HbA1c levels in the overall management of diabetic patients. However, baseline HbA1c did not emerge as an independent predictor in this cohort. Notably, Faricimab provided clear anatomical and functional benefits regardless of glycemic control, confirming its efficacy as a treatment for DME.