To evaluate visual and anatomical outcomes after switching to faricimab in Singaporean patients with diabetic macular edema (DME) previously treated with other anti‑vascular endothelial growth factor (VEGF) agents or therapies. This was a retrospective single-center cohort study with chart review. The subjects were patients with DME at the Singapore National Eye Centre who had a suboptimal response to prior therapy and therefore switched to faricimab between 2022 and 2024; all received three or four consecutive intravitreal faricimab injections on the basis of the treating physician’s clinical decision. We analyzed changes in best available visual acuity (BAVA; ETDRS letters) and central subfield thickness (CST) on optical coherence tomography (OCT) from baseline to the first follow-up after the loading of faricimab. The initial loading regimen, consisting of three or four consecutive intravitreal faricimab injections, was determined by the treating clinician. We also conducted a subgroup analysis comparing outcomes between the three-injection and four-injection groups. A total of 157 eyes from 131 patients were included, comprising 101 eyes in the three-injection group and 56 eyes in the four-injection group. The median duration of prior therapy was 1.8 years (interquartile range IQR 3.6). Mean BAVA improved significantly from 57.8 ± 16.5 to 62.4 ± 15.0 ETDRS letters at mean final follow-up of 6.9 weeks (p < 0.001). Mean CST decreased from 431.4 ± 129.4 µm to 334.2 ± 90 µm (p < 0.001). No significant differences in BAVA change (p = 0.39) or CST change (p = 0.58) were observed between the three‑ and four‑injection groups. Switching to faricimab resulted in significant short-term improvements in both visual acuity and retinal thickness even among patients with chronic DME who were previously receiving long-term treatment. Diabetic macular edema is a common eye problem in people with diabetes. It happens when fluid builds up in the central part of the retina, which can reduce vision. Some patients do not respond well enough to standard treatments. In this study, we looked at what happened when these patients were switched to faricimab, a newer medicine given by injection into the eye. We reviewed 157 eyes from 131 patients treated at the Singapore National Eye Centre. All patients had diabetic macular edema that had responded poorly to earlier treatment. After switching to faricimab, they received either three or four injections in a row, depending on the treating doctor’s decision. We measured changes in vision and retinal swelling after this initial treatment period. Vision improved after switching to faricimab. On average, patients gained about five letters on a standard eye chart used in research. Retinal swelling also improved, with the average thickness of the retina falling from 431 to 334 µm. These improvements were seen over a short follow-up period of about 7 weeks after the loading phase. We did not find a meaningful difference between patients who received three injections and those who received four injections. These findings suggest that switching to faricimab may help improve both vision and retinal swelling in patients with long-standing diabetic macular edema, even when previous treatments have not worked well enough.
Fukutsu et al. (Sun,) studied this question.