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Peer-reviewedCC BYPhotodiagnosis and Photodynamic Therapy

Epivascular glia and macular pigment changes after faricimab or aflibercept during the loading phase in diabetic macular edema: a prospective non-randomized pilot study

  • Gilda Cennamo1
  • Michele Rinaldi2
  • Erica Caporale2
  • Fabiana Iorio2
  • Davide Tramontano2
  • Ciro Costagliola2
  1. 1Corresponding author at: Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
  2. 2Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, 80131, Italy
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Abstract

Purpose: To explore short-term changes in epivascular glia (EVG), macular pigment optical density (MPOD), visual acuity, and retinal thickness after faricimab or aflibercept in treatment-naive eyes with center-involving diabetic macular edema (DME). Methods: This prospective, non-randomized pilot study included 30 eyes with DME and EVG on en face optical coherence tomography. Fifteen eyes received three monthly injections of faricimab 6 mg and 15 received aflibercept 2 mg. The primary exploratory outcome was complete EVG regression after loading. Secondary outcomes included best-corrected visual acuity (BCVA), central macular thickness (CMT), MPOD, fluid resolution, and resolution of traction-related abnormalities. Results: Complete EVG regression occurred in 12/15 eyes (80.0%) with faricimab and 6/15 (40.0%) with aflibercept (Fisher's exact p = 0.060). Resolution of traction- related abnormalities occurred in 11/15 (73.3%) and 5/15 eyes (33.3%), respectively (p = 0.066). Post-loading CMT was 274.5 ± 61.3 versus 328.7 ± 72.4 µm (unadjusted p = 0.035), MPOD was 0.46 ± 0.07 versus 0.39 ± 0.08 (unadjusted p = 0.017), and BCVA was 0.27 ± 0.14 versus 0.36 ± 0.16 logMAR (p = 0.112). Conclusions: EVG and traction- related outcomes were numerically more favorable with faricimab but were not statistically significant. Exploratory anatomical and MPOD differences require confirmation in larger randomized studies.

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Cite

BibTeXRIS
BibTeX
@article{cennamo2026epivascular,
  title = {{Epivascular glia and macular pigment changes after faricimab or aflibercept during the loading phase in diabetic macular edema: a prospective non-randomized pilot study}},
  author = {Gilda Cennamo and Michele Rinaldi and Erica Caporale and Fabiana Iorio and Davide Tramontano and Ciro Costagliola},
  journal = {Photodiagnosis and Photodynamic Therapy},
  year = {2026},
  month = oct,
  doi = {10.1016/j.pdpdt.2026.105687},
  url = {https://doi.org/10.1016/j.pdpdt.2026.105687},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Epivascular glia and macular pigment changes after faricimab or aflibercept during the loading phase in diabetic macular edema: a prospective non-randomized pilot study
AU  - Gilda Cennamo
AU  - Michele Rinaldi
AU  - Erica Caporale
AU  - Fabiana Iorio
AU  - Davide Tramontano
AU  - Ciro Costagliola
PY  - 2026
DA  - 2026/10/30
JO  - Photodiagnosis and Photodynamic Therapy
DO  - 10.1016/j.pdpdt.2026.105687
UR  - https://doi.org/10.1016/j.pdpdt.2026.105687
AB  - Purpose: To explore short-term changes in epivascular glia (EVG), macular pigment optical density (MPOD), visual acuity, and retinal thickness after faricimab or aflibercept in treatment-naive eyes with center-involving diabetic macular edema (DME). Methods: This prospective, non-randomized pilot study included 30 eyes with DME and EVG on en face optical coherence tomography. Fifteen eyes received three monthly injections of faricimab 6 mg and 15 received aflibercept 2 mg. The primary exploratory outcome was complete EVG regression after loading. Secondary outcomes included best-corrected visual acuity (BCVA), central macular thickness (CMT), MPOD, fluid resolution, and resolution of traction-related abnormalities. Results: Complete EVG regression occurred in 12/15 eyes (80.0%) with faricimab and 6/15 (40.0%) with aflibercept (Fisher's exact p = 0.060). Resolution of traction- related abnormalities occurred in 11/15 (73.3%) and 5/15 eyes (33.3%), respectively (p = 0.066). Post-loading CMT was 274.5 ± 61.3 versus 328.7 ± 72.4 µm (unadjusted p = 0.035), MPOD was 0.46 ± 0.07 versus 0.39 ± 0.08 (unadjusted p = 0.017), and BCVA was 0.27 ± 0.14 versus 0.36 ± 0.16 logMAR (p = 0.112). Conclusions: EVG and traction- related outcomes were numerically more favorable with faricimab but were not statistically significant. Exploratory anatomical and MPOD differences require confirmation in larger randomized studies.
SN  - 1572-1000
SN  - 1873-1597
ER  -