Zeitschrift für klinische und experimentelle Ophthalmologie
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Brolucizumab in Age-Related Macular Neovascularization (Brain Study): Efficacy, Optical Coherence Tomography Biomarkers and Safety Profile over 18 Months

Supriya Dabir, Arthi Mohankumar, Manoj Khatri, Mohan Rajan

Background: Brolucizumab is a new anti-Vascular Endothelial Growth Factor (anti-VEGF) in treatment of neovascular Age-related Macular Degeneration (nAMD) and Idiopathic Polypoidal Choroidal Vasculopathy (IPCV).

Materials and methods: A retrospective, consecutive, interventional studies from a tertiary eye hospital, where treatment naive and treatment switch patients were included. They underwent intravitreal injection Brolucizumab. Decision to reinject was made on presence of fluid on Spectral Domain Optical Coherence Tomography (SD OCT) or worsening of vision at follow-up. Outcome measures were change in Best Corrected Visual Acuity (BCVA), Central Subfield Thickness (CST) and changes in fluid (sub-retinal/intra-retinal/sub retinal pigment epithelium fluid) levels, Optical Coherence Tomography (OCT) biomarkers and safety analysis.

Results: A total of 59 eyes of 50 patients with a total of 132 intravitreal injections were included. There was a statistically significant improvement (p<0.05) in BCVA from baseline in treatment naive patients (mean BCVA at baseline 0.6 ± 0.41 and 0.37 ± 0.56). Mean baseline CST of all patients significant reduced from 582.92 ± 233.11 μm at baseline to 474.06 ± 252.89 μm at final treatment visit. Thirty-eight percentages of patients showed complete resolution of Sub- retinal Hyper-reflective Material (SHRM) after single injection. Interval between each subsequent injection increased from mean of 67 to 96 days in treatment switch and 47 to 151 days in treatment naive patients.

Conclusion: Brolucizumab promises reduced number of injections without any vision threatening complications.