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The effect of brolucizumab on diabetic macular edema and ischemia; a real-world analysis

Objective - The response to intravitreal brolucizumab on diabetic macular edema (DME) and macular ischemia was studied in treatment-refractory and treatment-naïve patients. - Methods - Patients with either recalcitrant (group 1) or treatment-naïve (group 2) DME were studied before and after intrav...

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Main Authors: Chronopoulos, Argyrios (Author) , Vidal-Oliver, Lourdes (Author) , Sas, Lea K. (Author) , Holzwarth, Jakob (Author) , Schutz, James (Author) , Hattenbach, Lars-Olof (Author)
Format: Article (Journal)
Language:English
Published: May 21, 2025
In: European journal of ophthalmology
Year: 2025, Pages: 1-10
ISSN:1724-6016
DOI:10.1177/11206721251340436
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1177/11206721251340436
Verlag, kostenfrei, Volltext: https://journals.sagepub.com/doi/10.1177/11206721251340436
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Author Notes:Argyrios Chronopoulos, Lourdes Vidal-Oliver, Lea K. Sas, Jakob W. Holzwarth, James Schutz and Lars-Olof Hattenbach
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Summary:Objective - The response to intravitreal brolucizumab on diabetic macular edema (DME) and macular ischemia was studied in treatment-refractory and treatment-naïve patients. - Methods - Patients with either recalcitrant (group 1) or treatment-naïve (group 2) DME were studied before and after intravitreal brolucizumab. All patients underwent a comprehensive ophthalmological examination including optical coherence tomography (OCT) and OCT-angiography (OCT-A). We compared the DME and macular/choriocapillaris ischemia before and after the loading dose. - Results - A total of 33 eyes of 26 patients were examined. 18 eyes were switched to brolucizumab, 15 eyes were treatment naive. All eyes responded with anatomical and functional improvement: group 1: 391 vs 298 μm (p = 0.005), 0.6 ± 0.4 logMAR vs. 0.4 ± 0.4 logMAR) (p = 0.01), group 2: 430 vs 281 μm (p = 0.0007), 0.5 ± 0.2 logMAR vs. 0.2 ± 0.2 logMAR (p = 0.004). In group 2 there was also significant improvement in retinal vascular parameters, especially in the central and inner circles of the ETDRS grid: central capillary density 6.55 vs 9.03 mm/mm2 (p = 0.008), inner 11.2 vs 13, 9 mm/mm2 (p = 0.02), central perfusion density 15.5% vs 20.7% (p = 0.02). Choriocapillaris flow deficit (CCFD%) also improved after the loading dose (40.3 vs. 35.3, p = 0.03). Although not statistically significant, there was also an improved foveal circularity. - Conclusion - Intravitreal brolucizumab leads to significant functional and anatomical improvement in diabetic macular edema and has also a beneficial effect on macular ischemia as shown by improvement in both retinal and choroidal perfusion.
Item Description:Gesehen am 02.09.2025
Physical Description:Online Resource
ISSN:1724-6016
DOI:10.1177/11206721251340436

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