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- Title
Switching from aflibercept to brolucizumab for the treatment of refractory neovascular age-related macular degeneration.
- Authors
Ota, Hikaru; Takeuchi, Jun; Nakano, Yuyako; Horiguchi, Etsuyo; Taki, Yosuke; Ito, Yasuki; Terasaki, Hiroko; Nishiguchi, Koji M.; Kataoka, Keiko
- Abstract
Purpose: To examine the 16-week outcomes of switching to brolucizumab in eyes with neovascular age-related macular degeneration (nAMD) refractory to aflibercept. Study design: Retrospective observational study. Methods: Data of eyes with nAMD who switched to brolucizumab because of resistance to aflibercept were collected. The best-corrected visual acuity (BCVA; in logarithm of the minimum angle of resolution), central retinal thickness (CRT), central choroidal thickness (CCT), and exudative status on optical coherence tomography were analyzed. Results: A total of 48 eyes of 48 patients were reviewed. At 4 to 7 weeks after switching, BCVA changed from 0.26 ± 0.19 to 0.25 ± 0.21 (not significant; P = 0.95), but CRT significantly decreased from 298.9 ± 108.4 µm to 241.9 ± 92.5 µm (P < 0.001) and CCT from 182.6 ± 89.3 µm to 169.7 ± 82.6 µm (P < 0.001). Of the 23 eyes refractory to monthly aflibercept injections, 12 (52.2%) achieved a dry macula, and 8 (34.8%) reduced exudative changes at 1 month. At 16 weeks, 31 eyes (64.6%) achieved the treatment interval ≥ 8 weeks. Two patients (4.2%) dropped out, 7 eyes (14.6%) developed intraocular inflammation (IOI), and 8 eyes (16.7%) switched back to aflibercept because of the failure to extend the treatment interval ≥ 8 weeks. Conclusion: Switching to brolucizumab in eyes refractory to aflibercept conferred favorable outcomes in controlling exudative changes. However, IOI and the regulation of the treatment interval to at least 8 weeks during the maintenance phase disrupted the continuation of brolucizumab treatment.
- Subjects
RETINAL degeneration; AFLIBERCEPT; VASCULAR endothelial growth factor antagonists; CHOROID; OPTICAL coherence tomography
- Publication
Japanese Journal of Ophthalmology, 2022, Vol 66, Issue 3, p278
- ISSN
0021-5155
- Publication type
Article
- DOI
10.1007/s10384-022-00908-1