J Retin.  2022 Nov;7(2):113-120. 10.21561/jor.2022.7.2.113.

Short-term Effect and Safety of a Single Intravitreal Brolucizumab in Refractory Neovascular Age-related Macular Degeneration

• Kang M
• Lee CS
• Kim YJ
• Kim HR
• Kwak JJ
• Ryu SY
• Kim DW
• Park HS
• Han JY
• Kim YJ
• Choi EY
• Byeon SH
• Kim SS

• KMID: 2552140
• DOI: http://doi.org/10.21561/jor.2022.7.2.113

Abstract

Purpose
To assess effect of brolucizumab in Korean patients, and also analyze incidence of intraocular inflammation (IOI) rate, clinical features, treatment and prognosis.
Methods
We reviewed EMR chart of history of brolucizumab injection patients retrospectively in Severance Hospital. Total 101 eyes of 92 patients were included. Patients consist of 80 wet age-related macular degeneration (wAMD) and 21 polypoidal choroidal vasculopathy (PCV). Demographic data, best corrected visual acuity (BCVA), anatomical features as central macular thickness, subretinal fluid (SRF), intraretinal fluid (IRF), height of pigment epithelium detachment (PED) through optical coherence tomography, incidence of IOI and their clinical feature, treatment, prognosis were assessed.
Results
BCVA and subfoveal choroidal thickness of patients showed no statistical significancy. Central macular thickness, IRF and PED height showed statistically significant effect in 1 month after injection. SRF was improved significantly during 2 months of follow up. In subgroup analysis of PCV group, BCVA, subfoveal choroidal thickness, IRF showed no statistical significance. Central macular thickness and SRF showed improvement throughout 2 months. PED height showed 1 month of statistically significant effectiveness. There were six cases (5.9%) of IOI in total 101 eyes of brolucizumab injection cases. One case (0.99%) among IOI patients showed non-occlusive vasculitis. There was no case of occlusive vasculitis in our study. All cases were resolved after steroid treatment, topical or combination of topical and subtenon injection.
Conclusions
Intravitreal injection of brolucizumab in Korean wAMD patients and PCV subgroups refractory to other anti-VEGF showed effectiveness in central macular thickness, IRF, SRF, and PED height. Incidence of IOI was 5.9% and no case of severe visual acuity deterioration. All IOI cases were resolved after topical or subtenon triamcinolone injection.

Keyword

Brolucizumab; Intraocular inflammation; Polypoidal choroidal vasculopathy; Wet age-related macular degeneration