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Multicenter Study
. 2023 Oct;71(10):3375-3380.
doi: 10.4103/IJO.IJO_210_23.

Efficacy of a single injection of brolucizumab in neovascular age-related macular degeneration on visual acuity and micromorphometry

Shrinivas Joshi  1 , Lalit Verma  2 , Guruprasad Ayachit  1 , Rajashree Salvi  1 , Yusra Asad  2 , Avnindra Gupta  2 , Anuja Patil  2 , Apoorva Ayachit  1
Affiliations
Multicenter Study

Efficacy of a single injection of brolucizumab in neovascular age-related macular degeneration on visual acuity and micromorphometry

Shrinivas Joshi et al. Indian J Ophthalmol. 2023 Oct.

Abstract

Purpose: To assess short-term efficacy of a single injection of brolucizumab in neovascular AMD.

Methods: This was a multicenter, retrospective chart review of 25 eyes of 25 patients who received a single injection of brolucizumab. Visual acuity (VA) and optical coherence tomography (OCT) features such as central subfield thickness (CSFT), subretinal fluid (SRF), intraretinal fluid, and pigment epithelial detachment (PED) were recorded at baseline, first month, and third month.

Results: Of the 25 eyes, 14 eyes were treatment-naïve and 11 eyes had received previous injections. VA improved from 0.68 ± 0.59 log MAR at baseline to 0.31 ± 0.43 log MAR at the end of 3 months. SRF height in first and third month was significantly reduced from baseline (P < 0.001). Subretinal hyperreflective material height significantly reduced from baseline (P value 0.008 at first month and 0.01 at third month, respectively). CSFT was 464.16 ± 247.97 microns at baseline and showed a significant reduction in first month (P < 0.001) and third month (P < 0.001). There was a significant reduction of PED height from baseline at both follow-ups. None of the eyes showed a recurrence of fluid at the end of 3 months.

Conclusion: Our study demonstrated sustained improvement in VA and OCT parameters after a single injection of brolucizumab at 3 months. A longer follow-up may demonstrate even farther effects of a single injection.

Keywords: Brolucizumab; neovascular age-related macular degeneration; pigment epithelial detachment; subretinal fluid; subretinal hyperreflective material; type 1 macular neovascularization.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
(a) A 51-year-old patient with two large PEDs in the right eye with a flat irregular PED (FIPED) connecting the two, along with subretinal fluid received a single injection of Brolucizumab. (b) At first month, there was marked reduction of PED height as well as SRF. (c) At 2 months, there was resolution of the SRF with persistence of a flat irregular PED continuous with the pre-existing “bridging” FIPED. (d) At end of 3 months also, this effect was maintained with a visual acuity of 6/9 N6
Figure 2
Figure 2
(a) A 66-year-old woman undergoing switch treatment with brolucizumab at baseline had subretinal fluid with bacillary layer detachment, PED, intraretinal hyper reflective foci (HRF), and spongy edema. (b) At the end of 3 months, the resolution of SRF and IRF and reduction of PED and HRF were maintained with a visual acuity of 6/12, N10
Figure 3
Figure 3
A 65-year-old male patient underwent switch treatment with brolucizumab after receiving 13 injections in the past. (a) Before injection with brolucizumab, there were large cystoid spaces at the fovea, SHRM, and FIPED in the nasal parafovea. (b) At first month, there was near-complete resolution of the cystoid spaces, reduction in SHRM height, and a concurrent epiretinal membrane (ERM). (c) At third month, the effect was maintained with a slight increase in the height of the nasal FIPED. The vision at 3 months improved remarkably to 6/6 N6
See this image and copyright information in PMC

References

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