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

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. Keywords: faricimab, retinal vein occlusion, macular edema, optical coherence tomography, real-world study, visual acuity