The Effect of Intravitreal Faricimab in Patients with Refractory Macular Edema and Refractory Age Elated Macular Degeneration

Background: This study was designed to assess the anatomical and functional responses in patients with refractory diabetic macular edema (DME), refractory retinal vein occlusion edema (RVO), and refractory neovascular age-related macular degeneration (nAMD) with suboptimal response to anti-VEGF treatments, specifically Bevacizumab or Aflibercept. Method: This prospective study includes 45 eyes of 35 patients with refractory (DME), (RVO) and (nAMD) previously treated with intravitreal Bevacizumab or/ and Aflibercept. Among the reasons for switching persistent retinal fluid, lack of improvement in best-corrected visual acuity (BCVA) and central retinal thickness (CRT). Patients received 3 monthly loading doses of Faricimab. Over 12 months, this study encompassed all essential stages, including patient recruitment, baseline evaluations, treatment administration, follow-up assessments, data analysis. Results: Switching to Faricimab show a significant improvement in the visual acuity (median VA decreased from 0.6 to 0.3) and a significant decrease in central retinal thickness (median central retinal thickness reduced from 411.0 to 289.0), subretinal fluid (proportion of eyes with SRF decreased from 53.33% to 6.66%), and intraretinal fluid (proportion of eyes with IRF decreased from 77.77% to 35.55%) after starting Faricimab treatment for all eyes. While Intraocular pressure remained stable over the course of the study. Conclusion: switching to Faricimab showed statistically significant improvements in both morphological and functional characteristics showing that Faricimab is a promising treatment option, particularly for patients with persistent or refractory macular edema.