Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
PLoS One. 2021 Dec 6;16(12):e0259879. doi: 10.1371/journal.pone.0259879. eCollection 2021.
To analyze the risk factors associated with emerging intraocular inflammation (IOI) after intravitreal brolucizumab injection (IVBr) to treat age-related macular degeneration (AMD).
This study included 93 eyes of 90 patients. The incidence of emerging IOI was analyzed. The patients were classified into IOI or non-IOI groups, and background clinical characteristics in each group were compared.
IOI occurred in 14 eyes of 14 cases (16%; five women, nine men [5:9]; IOI group) after IVBr; contrastingly, no IOI occurred in 76 patients (10 women, 66 men [10:66]; non-IOI group). The mean ages in IOI and non-IOI groups were 79.4 ± 8.1 and 73.8 ± 8.9 years old, respectively, and the average age in the IOI group was significantly higher than that in the non-IOI group (P = 0.0425). In addition, the percentages of females in the IOI and non-IOI groups were 43% and 13%, respectively, and IOI occurred predominantly in females (odds ratio: 4.95, P = 0.0076). Moreover, the prevalence of diabetes in the IOI and non-IOI groups was 64% and 32%, respectively, with a significant difference (odds ratio: 3.90, P = 0.0196). In contrast, the prevalence of hypertension in the IOI and non-IOI groups was 36% and 57%, respectively, with no significant difference (P = 0.15).
The comparison of clinical profiles of IOI or non-IOI cases in IVBr treatment for AMD suggests that the risk factors for IOI are old age, female sex, and history of diabetes; however, IOI with vasculitis or vascular occlusion in this cohort does not seem to cause severe visual impairment. Further studies are required to investigate potential risk factors for IOI.
分析玻璃体内注射布罗利珠单抗(IVBr)治疗年龄相关性黄斑变性(AMD)后出现的眼内炎症(IOI)的相关风险因素。
本研究纳入了 90 例患者的 93 只眼。分析了新发 IOI 的发生率。将患者分为 IOI 或非 IOI 组,比较各组的背景临床特征。
IVBr 后,14 只眼中发生了 14 例 IOI(16%;5 例女性,9 例男性[5:9];IOI 组);相比之下,76 例患者中未发生 IOI(10 例女性,66 例男性[10:66];非 IOI 组)。IOI 组和非 IOI 组的平均年龄分别为 79.4±8.1 岁和 73.8±8.9 岁,IOI 组的平均年龄明显高于非 IOI 组(P=0.0425)。此外,IOI 组和非 IOI 组女性的比例分别为 43%和 13%,IOI 主要发生在女性中(优势比:4.95,P=0.0076)。此外,IOI 组和非 IOI 组糖尿病的患病率分别为 64%和 32%,差异有统计学意义(优势比:3.90,P=0.0196)。相比之下,IOI 组和非 IOI 组高血压的患病率分别为 36%和 57%,差异无统计学意义(P=0.15)。
对 IVBr 治疗 AMD 中 IOI 或非 IOI 病例的临床特征进行比较,提示 IOI 的危险因素为年龄较大、女性、糖尿病史;然而,本队列中伴有血管炎或血管阻塞的 IOI 似乎不会导致严重的视力损害。需要进一步研究来探讨 IOI 的潜在风险因素。