Grewal Dilraj S, Wykoff Charles C, D'Souza Divya, Jehl Valentine, Alecu Iulian, Jaffe Glenn J
Department of Ophthalmology, Duke University, Durham, North Carolina.
Retina Consultants of Texas, Houston, Texas.
Ophthalmol Sci. 2023 Jul 1;4(1):100361. doi: 10.1016/j.xops.2023.100361. eCollection 2024 Jan-Feb.
The aim of this analysis was to characterize the spectrum of inflammatory changes arising from brolucizumab use in routine clinical practice.
Retrospective analysis of fluorescein angiography (FA), fundus photography (FP) and OCT images taken at the time of adverse event.
Brolucizumab-treated patients with neovascular age-related macular degeneration with retinal vasculitis (RV) and/or retinal vascular occlusion (RO) reported to Novartis Patient Safety between February 2020 and January 2021.
Ocular images were reviewed by an external reading center using predefined grading lists for FA, FP, and OCT.
Classification of images, the most common imaging features of RV and/or RO by each imaging modality, and the anatomical location of the adverse event in relation to the macula.
Gradable images (N = 475; 222 eyes; 198 patients) were classified as RV only (n = 72); RO only (n = 9), RV + RO (n = 63); posterior segment intraocular inflammation (n = 31); or none by imaging (n = 47). Of the 144 eyes with RV and/or RO, the most common imaging features were vascular leakage on FA, perivascular sheathing on FP, and hyperreflective dots in the vitreous humor on OCT. Retinal vascular occlusion was mainly branched and arterial, affecting multiple vessels.
Although no distinct inflammatory phenotype pathognomonic to brolucizumab-related inflammation was identified, this study increases our understanding of the spectrum of posterior segment inflammatory changes that may occur in brolucizumab-treated neovascular age-related macular degeneration patients, highlighting the potential value of widefield retinal imaging and angiography to detect these inflammatory adverse events.
Proprietary or commercial disclosure may be found after the references.
本分析旨在描述在常规临床实践中使用布罗卢izumab引发的炎症变化谱。
对不良事件发生时拍摄的荧光素血管造影（FA）、眼底摄影（FP）和光学相干断层扫描（OCT）图像进行回顾性分析。
2020年2月至2021年1月期间向诺华患者安全部门报告的接受布罗卢izumab治疗的患有视网膜血管炎（RV）和/或视网膜血管阻塞（RO）的新生血管性年龄相关性黄斑变性患者。
由外部阅片中心使用针对FA、FP和OCT的预定义分级列表对眼部图像进行评估。
图像分类、每种成像方式下RV和/或RO最常见的成像特征，以及不良事件相对于黄斑的解剖位置。
可分级图像（N = 475；222只眼；198例患者）被分类为仅RV（n = 72）；仅RO（n = 9），RV + RO（n = 63）；后段眼内炎症（n = 31）；或成像未发现异常（n = 47）。在144只患有RV和/或RO的眼中，最常见的成像特征是FA上的血管渗漏、FP上的血管周围鞘膜形成以及OCT上玻璃体中的高反射点。视网膜血管阻塞主要为分支状和动脉性，累及多条血管。
尽管未发现与布罗卢izumab相关炎症具有特异性的独特炎症表型，但本研究增进了我们对布罗卢izumab治疗的新生血管性年龄相关性黄斑变性患者可能发生的后段炎症变化谱的理解，突出了广角视网膜成像和血管造影在检测这些炎症性不良事件方面的潜在价值。
专有或商业披露信息可在参考文献之后找到。
