First-year real-world experience of intravitreal brolucizumab injection for refractory neovascular age-related macular degeneration.

IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Japanese Journal of Ophthalmology Pub Date : 2024-11-05 DOI:10.1007/s10384-024-01134-7
Jeong Hyun Lee, Joo Young Shin, Jeeyun Ahn
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Abstract

Purpose: To investigate the first-year real-world anatomical and functional outcomes of intravitreal brolucizumab injection in eyes with refractory neovascular age-related macular degeneration (nAMD).

Study design: Retrospective observational study.

Methods: nAMD patients who showed poor response to previous anti-vascular endothelial growth factor (VEGF) agents were switched to brolucizumab. Functional and anatomical outcomes were evaluated at initial treatment of nAMD, after treatment with other anti-VEGF agents and after switching and treating with brolucizumab for 1 year. Safety profile was also evaluated after brolucizumab injection. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), subfoveal choroidal thickness (SFCT), and the presence of fluid in different compartments (intraretinal fluid [IRF], subretinal fluid [SRF], pigment epithelial detachment [PED]) were assessed at each time point.

Results: A total of 40 eyes of 40 patients were included in the study. BCVA remained unchanged throughout treatment (p > 0.05). CFT did not change after treatment with other anti-VEGF agents (p = 0.588) but decreased after switching to brolucizumab (p < 0.001). SFCT decreased after treatment with other anti-VEGF agents (p = 0.025) but not after switching to brolucizumab (p = 0.236). Presence of SRF (p = 0.001) and PED (p = 0.001) decreased significantly after switching to brolucizumab, despite their persistence with prior treatments using other anti-VEGF agents. However, IRF persisted even after switching to brolucizumab (p = 0.745). Intraocular inflammation (IOI)-related adverse events were reported in 3 eyes (7.14%).

Conclusion: Analysis of first-year real-world outcomes after switching to brolucizumab in nAMD patients refractory to other anti-VEGF agents showed improved anatomic outcomes, limited functional improvement and low incidence of IOI-related adverse events.

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玻璃体内注射肉毒杆菌治疗难治性新生血管性年龄相关性黄斑变性的第一年真实体验。
目的:调查难治性新生血管性年龄相关性黄斑变性(nAMD)患者玻璃体内注射博路单抗第一年的实际解剖和功能效果:研究设计:回顾性观察研究。方法:对之前的抗血管内皮生长因子(VEGF)药物反应不佳的 nAMD 患者改用肉毒杆菌。在最初治疗 nAMD 时、使用其他抗血管内皮生长因子药物治疗后以及换用肉毒杆菌单抗并治疗 1 年后,对功能和解剖结果进行评估。此外,还评估了注射博卢单抗后的安全性。在每个时间点评估最佳矫正视力(BCVA)、中心眼窝厚度(CFT)、眼窝下脉络膜厚度(SFCT)以及不同区域的积液情况(视网膜内积液[IRF]、视网膜下积液[SRF]、色素上皮脱落[PED]):研究共纳入了 40 名患者的 40 只眼睛。在整个治疗过程中,BCVA 保持不变(P > 0.05)。在使用其他抗 VEGF 药物治疗后,CFT 没有变化(p = 0.588),但在改用博路单抗治疗后,CFT 有所下降(p 结论:博路单抗的治疗效果与其他抗 VEGF 药物相同:对其他抗血管内皮生长因子药物难治的 nAMD 患者改用肉毒珠单抗治疗后第一年的实际疗效分析表明,解剖结果有所改善,功能改善有限,与 IOI 相关的不良事件发生率较低。
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来源期刊
CiteScore
4.80
自引率
8.30%
发文量
65
审稿时长
6-12 weeks
期刊介绍: The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication. Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.
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