Photo Credit: Dr. Microbe

The following is a summary of “Conversion to faricimab after prior anti-vascular endothelial growth factor therapy for persistent diabetic macular oedema,” published in the February 2024 issue of Ophthalmology by Durrani et al.

Researchers conducted a retrospective study to evaluate anatomical and functional results in eyes with persistent diabetic macular edema (pDME) transitioning from long-term anti-vascular endothelial growth factor (VEGF) therapy to intravitreal faricimab.

They included patients with pDME undergoing chronic anti-VEGF therapy, who were transitioned to faricimab and received a minimum of 3 injections at our institution (between April 2022 and May 2023). Exclusions comprised those with complete response to prior treatment and those who shifted to extended treatment intervals due to recent steroid or laser therapy within six months before the switch. Clinical and imaging data were retrieved from electronic medical records, with central foveal thickness (CFT) and Snellen visual acuity (VA) measured before and after the three intravitreal faricimab injections. Analysis of CFT and VA changes utilized generalized estimating equations.

The results showed that 69 eyes from 53 patients fulfilled the inclusion criteria. The average age was 68.6±9.0 years, with a mean of 18.1±16.0 injections before switching to faricimab. Before the switch, the mean logarithm of the minimal angle of resolution VA was 0.40±0.30 (Snellen equivalent 20/50), and after three faricimab injections, it was 0.38±0.27 (Snellen equivalent 20/48), with no significant difference observed (P=0.397). Mean CFT improved from 380±155 microns to 323±147 microns (P<0.001). No ophthalmic or systemic adverse events were reported.

Investigators concluded that Faricimab offers anatomical improvement without vision loss for pDME despite prior anti-VEGF therapy. 

Source: bjo.bmj.com/content/early/2024/02/12/bjo-2023-324394