Brolucizumab for recalcitrant macular neovascularization in age-related macular degeneration with pigment epithelial detachment: original research article

Purpose - To analyze anatomic and functional response to intravitreal brolucizumab in age-related macular degeneration recalcitrant to previous intravitreal anti-VEGF therapies. - Methods - In this monocentric, one arm, retrospective study, eyes affected by neovascular age-related macular degenerati...

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Hauptverfasser: Chronopoulos, Argyrios (VerfasserIn) , Huynh, Elisa (VerfasserIn) , Ashurov, Agharza (VerfasserIn) , Schutz, James S (VerfasserIn) , Jonas, Jost B. (VerfasserIn) , Hattenbach, Lars-Olof (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2024
In: European journal of ophthalmology
Year: 2024, Jahrgang: 34, Heft: 2, Pages: 487-496
ISSN:1724-6016
DOI:10.1177/11206721231187663
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1177/11206721231187663
Verlag, lizenzpflichtig, Volltext: https://journals.sagepub.com/doi/10.1177/11206721231187663
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Verfasserangaben:Argyrios Chronopoulos, Elisa Huynh, Agharza Ashurov, James S Schutz, Jost B Jonas and Lars-Olof Hattenbach

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520 |a Purpose - To analyze anatomic and functional response to intravitreal brolucizumab in age-related macular degeneration recalcitrant to previous intravitreal anti-VEGF therapies. - Methods - In this monocentric, one arm, retrospective study, eyes affected by neovascular age-related macular degeneration (nAMD) resistant to other intravitreally injected anti-vascular endothelial growth factor inhibitors were switched to intravitreal brolucizumab. All patients underwent ophthalmological examinations at baseline and in regular follow-up intervals. Best registered visual acuity (BRVA), Goldmann tonometry, intraocular pressure (IOP), central retinal thickness (CRT) and pigment epithelial detachment (PED) characteristics were analyzed at initiation of anti-VEGF treatment, at treatment switch, and at the end of brolucizumab loading phase. - Results - The study included 20 eyes of 18 consecutively treated patients (age: 77 ± 6 years). All eyes had macular neovascularization with PED. Previous treatments included intravitreal aflibercept, bevacizumab, and ranibizumab and had not resulted in a significant improvement in BRVA (0.5 ± 0.5 logMAR vs 0.5 ± 0.6 logMAR) or mean CRT (320 ± 60 µm vs 313 ± 83 µm) up to treatment switch to brolucizumab. At the end of the brolucizumab loading phase, there was significant improvement for both BRVA (0.3 ± 0.2 logMAR, P < 0.05) and CRT (264 ± 55 µm, P < 0.05). Under previous anti-VEGF therapy, there was a significant increase/deterioration in both PED area (2.68 mm2 to 5.18 mm2, P < 0.05) and PED volume (0.39 mm3 to 1.07 mm3, P < 0.05); however, both parameters improved after switching to brolucizumab (3.81 mm2 and 0.37 mm3, P < 0.05). - Conclusion - Our results suggest a favourable anatomical and visual response after treatment switch to brolucizumab in patients with nAMD refractory to previous anti-VEGF agents. 
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