Vitreo-Retina Services, Disha Eye Hospitals, Kolkata, West Bengal, India.
Netralayam Super Speciality Eye Care Centre, Kolkata, West Bengal, India.
Indian J Ophthalmol. 2022 Apr;70(4):1295-1299. doi: 10.4103/ijo.IJO_2513_21.
To report the initial experience of managing treatment-resistant and treatment-naïve eyes with polypoidal choroidal vasculopathy (PCV) by using brolucizumab 6 mg.
This was a retrospective multicentric series of all consecutive eyes with PCV treated with brolucizumab. Treatment resistance was defined as taking at least six prior anti-VEGF injections over the past 1 year and showing persistent disease activity in the form of intra (IRF) or subretinal fluid (SRF) or both. All patients were treated on a pro re nata (PRN) basis and followed up monthly. Retreatment was considered when either SRF or IRF were present at any time point during the study.
We included 21 eyes of 21 patients with PCV with a mean age of 65.1 ± 9.9 years, of which 16 eyes (76%) were treatment-resistant. The mean follow-up period from receiving the first brolucizumab was 27.3 ± 3.3 weeks. Of the 21 eyes, seven eyes (33%) received three injections during follow-up, 13 eyes (62%) received two injections, and one eye received one injection. The mean injection-free interval was 12 ± 1.2 weeks. The median pretreatment vision was 0.6 logMAR (IQR = 0.47-1 logMAR) and improved to 0.3 logMAR (IQR = 0.25-0.6 logMAR), whereas the mean macular thickness improved from 443 ± 60 μm at baseline to 289 ± 25 μm (P < 0.001) at the last follow-up period. None of the eyes experienced any intraocular inflammation across 48 injection sessions.
Brolucizumab is safe and effective in controlling PCV disease in both treatment-resistant and treatment-naïve eyes.
报告使用 6mg 布罗利珠单抗治疗耐药和初治息肉状脉络膜血管病变（PCV）眼的初步经验。
这是一项回顾性多中心系列研究，纳入了所有接受布罗利珠单抗治疗的 PCV 连续眼。治疗耐药性定义为过去 1 年内至少接受了 6 次抗 VEGF 注射，并且以视网膜内（IRF）或视网膜下液（SRF）或两者均存在的持续性疾病活动形式表现。所有患者均根据需要进行治疗（PRN），并每月进行随访。在研究期间的任何时间点，如果存在 SRF 或 IRF，则考虑进行再治疗。
我们纳入了 21 名患者的 21 只眼 PCV，平均年龄为 65.1±9.9 岁，其中 16 只眼（76%）为治疗耐药。从首次接受布罗利珠单抗治疗到开始随访的平均时间为 27.3±3.3 周。在 21 只眼中，有 7 只眼（33%）在随访期间接受了 3 次注射，13 只眼（62%）接受了 2 次注射，1 只眼接受了 1 次注射。平均无注射间隔为 12±1.2 周。治疗前视力中位数为 0.6 logMAR（IQR=0.47-1 logMAR），改善至 0.3 logMAR（IQR=0.25-0.6 logMAR），平均黄斑厚度从基线时的 443±60μm 改善至最后随访时的 289±25μm（P<0.001）。在 48 次注射过程中，没有任何眼发生任何眼内炎症。
布罗利珠单抗在控制耐药和初治息肉状脉络膜血管病变眼的疾病方面是安全有效的。
