ASSOCIATION BETWEEN BASELINE GLYCATED HEMOGLOBIN LEVELS AND FUNCTIONAL AND ANATOMICAL OUTCOMES AFTER FARICIMAB LOADING PHASE IN DIABETIC MACULAR EDEMA.

Abstract

To evaluate whether baseline glycosylated hemoglobin (HbA1C) levels play a predictive role in faricimab loading phase outcomes. In addition, the authors assessed the efficacy of faricimab loading phase for diabetic macular edema (DME). The authors conducted a retrospective, multicentric, interventional cohort study including 74 eyes, presenting with a central macular thickness (CMT) >280 µ m, visual acuity > 20/200, and optical coherence tomography-based diagnosis of DME. A statistically significant negative correlation was found between baseline HbA1c and the change in visual acuity after intravitreal faricimab injections (ρ = -0.32, P = 0.006). In multivariable regression, this association was not significant (β ≈ -0.026 logMAR per 1% HbA1c; P = 0.26; ≈ +1.3 letters/1%). The correlation between baseline HbA1c and the change in CMT was not statistically significant (ρ = +0.13, P = 0.279). Visual acuity improved significantly from baseline to posttreatment (-0.18 ± 0.22 ΔLogMAR; P < 0.0001). The mean baseline CMT (440.4 ± 152.9 µ m) significantly decreased (310.9 ± 87.8 µ m, P < 0.0001). The authors observed a significant reduction of hyperreflective foci ( P < 0.0001) and intraretinal fluid ( P = 0.0014), and the subretinal fluid decreased from 29.7% to 10.8% after treatment ( P = 0.023). Systemic glycemic status may influence functional outcomes, supporting the importance of maintaining optimal HbA1c levels in the overall management of diabetic patients. However, baseline HbA1c did not emerge as an independent predictor in this cohort. Notably, faricimab provided clear anatomical and functional benefits regardless of glycemic control, confirming its efficacy as a treatment for DME.