Intravitreal Brolucizumab for treatment of refractory macula edema due to neovascular age-related macular degeneration (real life data)

Author: Alaa Din Abdin (Germany)

Co-authors: Wissam Aljundi, Isabel Weinstein, Khalil Aljawhari, Shady Suffo, Berthold Seitz

Purpose

To assess the morphological and functional outcome of intravitreal brolucizumab for treatment of refractory macula edema due to neovascular age-related macular degeneration.

Setting/Venue

This retrospective study included 20 eyes from 18 patients with refractory macula edema due to neovascular age-related macular degeneration.

Methods

All patients were switched to brolucizumab after treatment with at least 2 other anti-VEGFs. All eyes received 3 brolucizumab 6 mg/0.05 ml intravitreal injections IVIs monthly as upload phase. Then eyes received an injection every 12 weeks and were interval adjusted to every 8 weeks if disease activity was present. Main outcome measures included: best corrected visual acuity (BCVA) and central macular thickness (CMT). In addition, we reported the adverse event rate.

Results

Patients age was 78±8 years on average. The number of previous anti-VEGF IVIs was 36±22 in the affected eyes before switching to brolucizumab. 100 brolucizumab IVIs (5 IVIs/eye) were carried out during the first seven months of treatment. BCVA (ETDRS) was 49±14 before treatment and improved to 58±17 at week 4 (p=0.1), to 64±17 at week 8 (p=0.04), to 64±26 at week 16 (p=0.03), to 65±18 at week 20 (p=0.01), to 60±20 at week 24 (p=0.02) and to 59±19 at week 28 (p=0.05). CMT was 335±78 μm before treatment and decreased to 317±106 μm at week 4 (p=0.2), to 307±42 μm at week 8 (p=0.4), to 324±37 μm at week 16 (p=0.9), to 309±40 μm at week 20 (p=0.6), to 333±39 μm at week 24 (p=0.9) and to 299±40 μm at week 28 (p=0.2). Finally, two cases of intraocular inflammation were diagnosed as adverse events.

Conlusions

Patients treated with intravitreal brolucizumab achieved statistically significant visual acuity improvement in the first seven months of treatment. Two cases of intraocular inflammation were reported during the first seven months of treatment.

Financial Disclosure

No financial disclosure.