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
- 1Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seochu-gu, Seoul 06591, Republic of Korea
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.
Related
- Binarization Parameters Affect Quantitative Choriocapillaris Biomarkers Derived from Optical Coherence Tomography Angiography
- From coronary computed tomography angiography to the cath lab: computed tomography-guided percutaneous coronary intervention of a high-risk left anterior descending artery lesion
- Test-bolus peak attenuation for predicting aortic enhancement in coronary computed tomography angiography: an exploratory subgroup analysis
- Incidental pulmonary nodules detected on computed tomography pulmonary angiography: prevalence and malignancy outcomes from a Thai tertiary-care center
- Serial bedside retinal optical coherence tomography angiography in sepsis associated circulatory dysfunction
BibTeX
@article{park2026switching,
title = {{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}},
author = {Young-Hoon Park and Joon Young Moon and Young Gun Park},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15218266},
url = {https://www.mdpi.com/2077-0383/15/21/8266},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - 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
AU - Young-Hoon Park
AU - Joon Young Moon
AU - Young Gun Park
PY - 2026
DA - 2026/10/23
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218266
UR - https://www.mdpi.com/2077-0383/15/21/8266
AB - 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.
SN - 2077-0383
ER -