Early Effect of Intravitreal Faricimab on Hard Exudates in Diabetic Macular Oedema

Résumé fourni par la source

Intravitreal faricimab is the first bispecific antibody to target vascular endothelial growth factor A (VEGF-A) and angiopoietin-2 (Ang-2). In the study reported here, we examined the early effect of intravitreal faricimab on hard exudates (HEs) in patients with diabetic macular oedema (DMO). Consecutive patients who were initiated on faricimab for centre-involving DMO associated with HEs between August 2022 and July 2023 were reviewed. Areas of HE were confirmed on colour fundus photographs taken at initiation of therapy and at the 6-month follow-up. ImageJ software was used for semi-automated segmentation and measurement of the HE area within the Early Treatment Diabetic Retinopathy Study (ETDRS) grid. Demographic data, including age, gender and ethnicity, as well as best-corrected visual acuity (BCVA), central retinal thickness (CRT) and macular volume (MV) were recorded. A total of 19 eyes from 16 patients were included in the study. Mean age of the cohort was 60.6 (range 49–71) years; ten eyes (53%) were treatment naïve. The median total HE area was reduced from 0.15 (interquartile range [IQR] 0.04–0.30) mm 2 to 0.10 (IQR 0.07–0.24) mm 2 by the 6-month follow-up. A greater reduction in total HE area was observed in treatment-naïve eyes (− 0.14 mm 2 ) compared with previously treated eyes (+ 0.05 mm 2 ), despite the former having a higher median baseline value (0.25 [IQR 0.15–0.47] mm 2 vs 0.05 [IQR 0.04–0.15] mm 2 ). Mean BCVA improved from LogMAR 0.26 ± 0.22 to 0.18 ± 0.19 ( p < 0.05), while mean CRT and MV reduced from 413 ± 108 to 340 ± 95 μm ( p < 0.001) and from 10.03 ± 1.41 to 9.20 ± 1.17 mm 3 ( p < 0.0001), respectively. Intravitreal faricimab may be associated with reduction of HE area in DMO within 6 months of initiation, with greater effects in treatment-naïve eyes. Further studies with longer follow-up are warranted to determine the durability of HE resolution and its comparison to intravitreal steroids and other anti-VEGF agents.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.