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Real-World Efficacy of Intravitreal Faricimab for Macular Edema Secondary to Retinal Vein Occlusion: Short-Term Outcomes and Optical Coherence Tomography Biomarker Analysis

Soichiro Inokuchi,Yuki Mizuki,Akihiro Kamata,Junji Onishi,Takahiko Hayashi,N. Mizuki

Published 2025 in Clinical Ophthalmology

ABSTRACT

Background Retinal vein occlusion (RVO) is the second most common retinal vascular disease and a major cause of visual impairment due to macular edema (ME). Faricimab, a novel bispecific antibody targeting both VEGF-A and angiopoietin-2, has shown promise in clinical trials; however, real-world data on its efficacy and safety for ME secondary to RVO (RVO-ME) remain limited. Objective To evaluate the short-term efficacy and safety of intravitreal faricimab for RVO-ME in a real-world Japanese clinical setting, and to explore associations between baseline optical coherence tomography (OCT) biomarkers and treatment outcomes. Methods This retrospective observational study was conducted at the International Goodwill Hospital, Yokohama, Japan, and included 23 eyes with RVO-ME treated with intravitreal faricimab. Changes in best-corrected visual acuity (BCVA, logMAR) and central subfield thickness (CST) over 3 months were assessed. Baseline OCT biomarkers were analyzed for associations with visual and anatomical responses. Subgroup analyses compared treatment-naïve and previously treated eyes. Results The median number of injections was 1, and 52.2% of eyes achieved complete resolution of macular fluid. Median BCVA improved significantly from 0.40 to 0.22 logMAR (p = 0.0025), and median CST decreased from 352 µm to 194 µm (p < 0.001). Greater CST reduction was observed in treatment-naïve eyes (p = 0.048) and in eyes with chronic cyst (p = 0.015). No OCT biomarker was significantly associated with BCVA improvement. No ocular or systemic adverse events were observed. Conclusion Intravitreal faricimab was effective and well-tolerated for RVO-ME in this real-world study. Even a single injection frequently led to anatomical and functional improvement. These results support the clinical utility of faricimab and suggest a potential role for OCT biomarkers in predicting treatment response.

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