Therapeutic Advances in Ophthalmology · Published 2026-07-01 · DOI 10.1177/25158414261465595
Giovanni William Oliverio, Irene Ingrande, Pasquale Aragona, Alessandro Meduri
Background: Diabetic macular edema (DME) is a leading cause of vision loss in working-age adults. Subfoveal neuroretinal detachment (SND) is an OCT phenotype associated with prominent subretinal fluid and inflammatory signaling, and prospective routine-care data on faricimab in treatment-naïve SND-DME are limited. Objectives: To evaluate functional and anatomical outcomes of faricimab in a prospective routine-care, phenotype-defined cohort of treatment-naïve eyes with DME and SND, and to explore OCT biomarkers associated with visual improvement. Design: Prospective, single-center, routine-care observational study. Methods: Forty eyes received intravitreal faricimab with a loading phase followed by a treat-and-extend regimen. Best-corrected visual acuity (BCVA), central subfield thickness (CST), and OCT biomarkers—intraretinal fluid (IRF), subretinal fluid (SRF), hyperreflective retinal spots (HRS), disorganization of the retinal inner layers (DRIL), ellipsoid zone (EZ) disruption, epiretinal membrane (ERM), and vitreomacular adhesion (VMA)—were assessed at baseline and weeks 20, 48, and 64. Results: At week 64, mean BCVA improved from 47.5 ± 22.5 to 55.7 ± 24.8 ETDRS letters ( p = 0.01), and CST decreased from 460 ± 99.5 µm to 325.2 ± 116 µm ( p < 0.0001). Complete resolution of SND/SRF occurred in 37 eyes (92.5%) after loading and in all eyes by week 48, with sustained absence through week 64. Mean HRS decreased from 28.1 ± 12.2 to 15.8 ± 8.7 ( p = 0.01), while DRIL, EZ disruption, ERM, and VMA showed no significant changes. In exploratory logistic regression, SRF resolution and lower baseline HRS were associated with greater visual gain ( p = 0.01), whereas EZ disruption was associated with poorer visual outcomes ( p = 0.03). Conclusion: In this prospective routine-care cohort of treatment-naïve DME eyes with SND, faricimab was associated with sustained visual and anatomical improvements through 64 weeks. Reductions in OCT-derived fluid and HRS were observed, and exploratory biomarker analyses suggested associations with visual outcomes requiring confirmation in larger comparative studies. Trial registration: Not applicable.
Abstract from DOAJ. Public domain (CC0 1.0).
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Oliverio, G., Ingrande, I., Aragona, P., et al. (2026). The efficacy of faricimab in patients with diabetic macular edema and serous neuroretina detachment. Therapeutic Advances in Ophthalmology. https://doi.org/10.1177/25158414261465595