Praxis Medical Insights

Est. 2024 • Clinical Guidelines Distilled

Made possible by volunteer editors from the University of Calgary & University of Alberta

Last Updated: 9/12/2025

Faricimab Treatment for Proliferative Diabetic Retinopathy with Macular Edema

Clinical Assessment and Indication

  • The American Academy of Ophthalmology recommends anti-VEGF therapy for patients with proliferative diabetic retinopathy and diabetic macular edema, as seen in this patient with confirmed PDR and regressed neovascularization and DME in both eyes 1, 2
  • The American Diabetes Association suggests that patients with minimal response to previous steroid injections, like this patient, should be considered for anti-VEGF therapy as the next step 2, 3

Treatment Rationale

  • The American Academy of Ophthalmology states that intravitreal anti-VEGF agents are the standard of care for center-involving diabetic macular edema, providing more effective treatment than monotherapy with laser 3
  • Faricimab (Vabysmo) is recommended as one of the anti-VEGF agents for treating center-involving DME, offering dual inhibition of angiopoietin-2 and VEGF-A pathways 3

Dosing Schedule Evidence

  • Guidelines from the American Academy of Ophthalmology recommend anti-VEGF administration every 4–8 weeks during the first 12 months of treatment, with fewer injections needed in subsequent years to maintain remission 3
  • The current 8-week dosing interval is supported by clinical evidence and guidelines for maintenance therapy after initial loading doses, as recommended by the American Academy of Ophthalmology 1

Continuation Criteria and Monitoring

  • Regular monitoring with optical coherence tomography (OCT) is essential to evaluate treatment response and determine the need for continued therapy, as suggested by the American Academy of Ophthalmology 1, 4
  • The typical treatment pattern for anti-VEGF therapy in DME is 6-8 injections in the first year, with fewer injections needed in subsequent years, according to the American Academy of Ophthalmology 1

Alternative Considerations

  • For eyes with persistent retinal thickening despite anti-VEGF therapy, laser treatment after 24 weeks or intravitreal triamcinolone may be considered, as recommended by the American Academy of Ophthalmology 1
  • The American Diabetes Association supports the continued use of anti-VEGF therapy in patients who have shown minimal response to steroid injections, like this patient 1, 3

REFERENCES

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