Work

Switching to Faricimab in Patients with Chronic Diabetic Macular Edema Refractory to Previous Anti-VEGF Therapy: Morphological and Functional Outcomes Including Optical Coherence Tomography Angiography Parameters

Year: 2026

Type: article

Abstract: Background/Objectives: Choriocapillaris flow impairment has been implicated in the pathogenesis of diabetic macular edema (DME), and choroidal vascular insufficiency has been proposed to contribute to poor treatment responses in chronic diseases. However, whether switching to faricimab can significantly improve choroidal and retinal perfusion in eyes with chronic treatment-refractory DME is unclear. Thus, we aimed to evaluate the morphological and functional effects of faricimab in eyes with DME that showed insufficient response to previous anti-vascular endothelial growth factor (VEGF) therapy. Methods: This single-center retrospective study included eyes with pretreated chronic DME that were switched to faricimab and received at least three consecutive injections. The main outcome measures were changes in central macular thickness (CMT), best-corrected visual acuity (BCVA), and optical coherence tomography angiography (OCTA) parameters before and after switching to faricimab. Results: Thirty-eight eyes previously treated with aflibercept-insufficient responders who switched to faricimab were analyzed. The mean CMT decreased significantly from 424.9 ± 164.4 µm before switching to 330.1 ± 75.2 µm after switching to faricimab (p < 0.001). BCVA improved significantly from 0.63 to 0.55 logMAR (p = 0.027). Among the OCTA parameters, choriocapillaris flow deficit and foveal circularity showed significant improvements after switching to faricimab (p = 0.008 and p = 0.048, respectively). Conclusions: Switching to intravitreal faricimab resulted in significant functional and anatomical improvements in eyes with refractory DME in a real-world setting. OCTA-derived microvascular markers also showed favorable changes, which may reflect a vascular-stabilizing effect.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm15218266

Authors: Young-Hoon Park, Joon Young Moon, Young Gun Park

Institutions: The Catholic University of Korea Seoul St. Mary's Hospital, Catholic University of Korea

Language: English

Topic: Retinal Diseases and Treatments

Subfield: Ophthalmology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,137