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. 2023 Mar 8:17:769-777.
doi: 10.2147/OPTH.S396304. eCollection 2023.

Morphological Macular Changes Under Brolucizumab Treatment for Neovascular Age-Related Macular Degeneration Refractory to Previous Anti-VEGF Treatment Compared with Treatment-Naive Eyes

Antony William  1 , Raoul Verma-Fuehring  1 , Sophia Kuehnel  1 , Dorothee Schwabe  1 , Daniel Kampik  1 , Winfried Goebel  1 , Jost Hillenkamp  1
Affiliations

Morphological Macular Changes Under Brolucizumab Treatment for Neovascular Age-Related Macular Degeneration Refractory to Previous Anti-VEGF Treatment Compared with Treatment-Naive Eyes

Antony William et al. Clin Ophthalmol. .

Abstract

Purpose: To evaluate the morphological macular changes and fluid dynamics under brolucizumab treatment in eyes refractory to previous anti-vascular endothelial growth factor (anti-VEGF) treatment for neovascular age-related macular degeneration (nAMD) compared with treatment-naive eyes.

Methods: Retrospective study of all eyes treated with brolucizumab for nAMD between 2020 and 2021 with a fixed injection regimen and one year follow-up. Treatment-naive eyes (TN) were compared with eyes refractory to previous treatment with bevacizumab, ranibizumab, or aflibercept (RT). The primary outcome measure was change of best-corrected visual acuity (BCVA). Secondary outcome measures included foveal central thickness (FCT), presence of intra- or subretinal fluid (IRF, SRF) and presence of pigment epithelial detachment (PED) at any time point during treatment in both groups.

Results: Seventeen TN eyes and 17 RT eyes were included. Mean BCVA and mean FCT in TN eyes had significantly improved after 3 months and continued to improve during treatment (p<0.05 and p=0.001, respectively). In RT eyes, mean BCVA did not change significantly while mean FCT had improved after 3 months of treatment and remained stable thereafter. SRF or PED were more frequent in RT eyes compared with TN eyes (p=0.003 and p=0.005, respectively).

Conclusion: After 3 months of treatment, the BCVA increased significantly only in TN eyes, while the FCT was significantly reduced in both groups. IRF appears to be similarly seen in both groups after the loading phase; however, SRF and PED appear to be more frequent in the RT eyes compared with TN eyes.

Keywords: RT; TN; refractory treatment; treatment naïve.

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Conflict of interest statement

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grant; participation in speaker’s bureaus; membership, employment or other equity interest) or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in subject matter or materials discussed in the manuscript.

Figures

Figure 1
Figure 1
Mean changes in the BCVA (logMAR) in treatment-naive and refractory treatment groups from baseline to the different visits. Statistical significant increase in the BCVA was seen in the TN group only, after the loading phase from the baseline and after 8th IVI from the loading phase.*Statistically significant result.
Figure 2
Figure 2
Mean changes in the FCT in the treatment-naive and refractory treatment groups from baseline to the different visits. Statistically significant reduction in the FCT was seen in both groups after the loading phase, however, further significant reduction in the FCT was only seen in the TN group 8th IVI from the loading phase. *Statistically significant result.
See this image and copyright information in PMC

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