Short-term clinical outcomes after switching to Faricimab in patients affected by macular edema secondary to retinal vein occlusion: A real-world study

Background To assess short-term clinical outcomes in patients with retinal vein occlusion (RVO)-related macular edema switched to Faricimab after a suboptimal response to previous intravitreal therapy. Methods In our retrospective single-center analysis, functional and anatomical changes of eyes affected by macular edema secondary to RVO were analyzed at baseline and four weeks after completing a three-injection Faricimab upload phase. Visual acuity (LogMAR) was analyzed as functional outcome measure, while central retinal thickness (CRT) and central retinal volume (CRV) were investigated as anatomical outcome measures. Further, a subgroup analysis compared treatment-related factors between patients exhibiting concurrent functional and anatomical improvements (full-responders) and those who did not (reduced-responders). Results A total of 21 eyes from 20 patients were included. Mean visual acuity improved modestly from 0.50 ± 0.52 to 0.40 ± 0.31 LogMAR, without reaching statistical significance ( p = 0.257). Significant reductions in CRT (350.2 ± 124.5 to 302.6 ± 74.6 µm; p = 0.037) and CRV (2.53 ± 0.46 to 2.34 ± 0.29 mm 3 ; p = 0.011) were noted. A positive correlation between CRT reduction and VA improvement was observed (r = 0.499; p = 0.021). In comparison, full-responders exhibited a significantly worse baseline LogMAR ( p = 0.041) and CRT ( p = 0.026). Conclusion In our study assessing the short-term effect of switching to intravitreal Faricimab, significant anatomical improvements were observed. Although no significant functional improvements were observed, likely reflecting a ceiling effect, visual acuity remained stable. Further studies are necessary to evaluate especially sustained functional outcomes under long-term Faricimab therapy.