LAUSR

Aims/Purpose: To report the changes in diabetic macular oedema (DME) and visual acuity (VA) in a single patient with bilateral DME treated with intravitreal 2 mg aflibercept (AFL) and 6 mg faricimab (FAR) in the context of a randomized clinical trial during 44 weeks.Methods: Interventional case report within a clinical trial.Results: A 57‐year‐old female patient entered a clinical trial to test the efficacy of FAR for DME. DME was present in both eyes. The left eye (LE) was randomized to masked treatment (which resulted to be 6 consecutive intravitreal FAR every 4 weeks followed by FAR every 8 weeks, totalling 8 injections). The RE received open label treatment with monthly AFL at baseline; and then every 4 weeks after Week 16, until Week 44, totalling 8 injections). Baseline best corrected VA was RE 50 letters and LE 64 letters; at Week 24, RE 46 and LE 62; and at Week 44, RE 46 and LE 76. Optical coherence tomography (OCT) revealed a progressive reduction of central macular thickness (CMT) as well as hard exudates and disorganization of retinal layers in both eyes. Angio OCT showed a progression of non‐perfused macular areas in both eyes; the anti‐vascular endothelial growth factor effect of the treatment induced a reduction in the severity of diabetic retinopathy in both eyes demonstrated by fluorescein angiography and colour fundus imaging.Conclusions: Our results show that treatment with AFL and FAR in the eyes of the same patient may cause a similar reduction in CMT, even though a better visual outcome was observed in the eye treaded by FAR.