Author: Federica Fossataro
Co-authors: Giulio Maione, Raffaele Liuzzi, Alfredo Pece
Abstract
Purpose: To evaluate activity biomarkers of choroidal neovascularization (CNV), such as intraretinal and subretinal fluid, subretinal hyperreflective material (SHRM), pigment epithelium detachment (PED) variations after Brolucizumab intravitreal injection in non-responder neovascular age-related macular degeneration (nAMD) patients using Optical Coherence Tomography (OCT).Venue: Eye Clinic, Melegnano Hospital, Milan
Methods: This is a prospective observational study. Patients diagnosed with nAMD non-responder to previous treatment with anti-VEGF agents and switched to Brolucizumab were enrolled. In order to be classified as non-responders, patients had to have persistent PED associated with intraretinal/subretinal fluid and/or SHRM after at least 3 additional consecutive anti-VEGF injections. All patients underwent structural OCT at the same retinal location at the time of the first Brolucizumab injection, one month and six months after treatment. Structural activity biomarkers were measured at each visit and their variations were analyzed using test McNemar and Wilxoson tests. A p value lower than <0.05 was considered statistically significant.
Results: Twenty eyes of twenty patients (mean age 77 SD± 6 years; 13 males) were enrolled in this study. The mean number of anti-VEGF treatments was 14.8 (SD± 4) during a mean follow-up period of 3 years from the first diagnosis to the last injection before switching. A significant reduction over time is observed for all variables examined (p<0.05). In particular the decrease is significant already after the first month for IRF, SRF and PED variations except for SHRM. A significant reduction of SHRM was significantly observed at 6 months.
Conclusion: Brolucizumab resulted in IRF and SRF reabsorption, SHRM contraction and PED’s height reduction at six months follow-up. Thus, Brolucizumab could represent a solid treatment option promoting a reduction of the structural activity biomarkers in non-responder nAMD.
