{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T13:24:18Z","timestamp":1786973058979,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T00:00:00Z","timestamp":1786752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Diabetic macular edema is caused by disruptions in the blood\u2013retinal barrier, resulting in leakage and inflammation, appearing in optical coherence tomography as retinal fluid, hard exudates, and hyper-reflective foci. This study aimed to assess volumetric changes in hyper-reflective foci and hard exudates in faricimab-treated diabetic macular edema in real-world practice. Methods: This retrospective longitudinal study included forty-four eyes with faricimab-treated diabetic macular edema and follow-up of \u226540 weeks. Optical coherence tomography scans were analyzed at baseline, post-loading, 6 months and 1 year. Hyper-reflective foci and hard exudates were quantified across macular subfields using a machine-learning algorithm with manual correction. Outcomes included volumetric changes, best-corrected visual acuity, and central subfield thickness. Early morphologic responders were defined post-loading by \u226520% central subfield thickness reduction and\/or central subfield thickness below 280 \u00b5m. Results: At 1 year, hyper-reflective foci and hard exudate volumes significantly decreased in the central subfield (median differences: \u22120.025 nL, p = 0.00028; \u22120.119 nL, p = 0.00025) and outer ring (\u22120.178 nL, p = 0.00041; \u22120.612 nL, p = 0.014). Hard exudate volume significantly decreased in the inner ring (\u22120.740 nL, p &lt; 0.0001). Best-corrected visual acuity and central subfield thickness improved significantly (\u22120.10 logarithm of the minimum angle of resolution (logMAR), p = 0.0018; \u221248 \u00b5m, p &lt; 0.0001). Total hyper-reflective foci volumes were similar between responders and non-responders. In contrast, hard exudate burden remained numerically higher in non-responders. Conclusions: During the year following the switch to faricimab, HRF and HE burden decreased alongside visual and anatomical improvement. HRF volumes were descriptively similar between early CST responders and non-responders, whereas HE burden remained numerically higher in non-responders.<\/jats:p>","DOI":"10.3390\/jcm15166319","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:01:26Z","timestamp":1786968086000},"page":"6319","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamics of Hyper-Reflective Foci and Hard Exudates in Diabetic Macular Edema Treated with Faricimab"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9432-3706","authenticated-orcid":false,"given":"Paul","family":"Widmann-Sedlnitzky","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim Lien","family":"Huber","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Steiner","sequence":"additional","affiliation":[{"name":"Institute of Medical Statistics, Center for Medical Data Science, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Gumpinger","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0233-359X","authenticated-orcid":false,"given":"Heiko","family":"Stino","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilman","family":"Schmoll","sequence":"additional","affiliation":[{"name":"Carl Zeiss Meditec AG, 73447 Oberkochen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7788-7311","authenticated-orcid":false,"given":"Ursula","family":"Schmidt-Erfurth","sequence":"additional","affiliation":[{"name":"Department of Oncology, Center for Cancer Research, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4920-2231","authenticated-orcid":false,"given":"Stefan","family":"Sacu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3902-239X","authenticated-orcid":false,"given":"Andreas","family":"Pollreisz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1056\/NEJMra1909637","article-title":"Evaluation and Care of Patients with Diabetic Retinopathy","volume":"382","author":"Jampol","year":"2020","journal-title":"N. 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