Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
Sci Rep. 2024 Jan 16;14(1):1441. doi: 10.1038/s41598-024-51315-0.
To report long-term outcomes of brolucizumab in neovascular age-related macular degeneration (nAMD) treatment. Records from 74 patients were retrospectively reviewed. Both naïve eyes and those previously treated with other antiVEGF agents were included. Primary outcomes included variation in best corrected visual acuity (BCVA), central subfield thickness (CST), intraretinal fluid (IRF), subretinal fluid (SRF), and pigment epithelial detachment (PED) dimensions. Outcomes were reviewed after the loading phase, at week 24, and at last follow-up. IOI occurrence represented the secondary outcome. BCVA improved significantly in both groups. In switched eyes, IRF and SRF were significantly reduced at every timepoint, with CST reduction from week 24 (p = 0.005). In naïve group, CST decreased from the loading phase (p = 0.006) and all patients showed dry macula from week 24. A significant reduction in PED maximum high was demonstrated in both groups. In seven naïve eyes, PED completely reabsorbed; a slight increase in PED horizontal maximal diameter was also observed from week 24. IOI occurred in 5.4% of cases. In conclusion, brolucizumab showed a strong drying effect, permitting functional improvement together with fluid reabsorption and an encouraging modification of PED dimension, especially on naïve patients. These results together with the extension of treatment intervals make brolucizumab an efficient therapeutic strategy for nAMD.
报告抗血管内皮生长因子单克隆抗体 brolucizumab 治疗新生血管性年龄相关性黄斑变性(nAMD)的长期疗效。回顾性分析了 74 例患者的病历。纳入初次治疗眼和既往接受过其他抗 VEGF 药物治疗的眼。主要疗效终点包括最佳矫正视力(BCVA)、中心视网膜厚度(CST)、视网膜内液(IRF)、视网膜下液(SRF)和色素上皮脱离(PED)的变化。在负荷期、24 周和末次随访时评估了疗效。眼内炎症(IOI)的发生为次要终点。两组的 BCVA 均显著提高。在转换治疗的眼中,IRF 和 SRF 在每个时间点均显著减少,CST 从 24 周开始减少(p=0.005)。在初次治疗的眼中,CST 从负荷期开始减少(p=0.006),所有患者在 24 周时均显示黄斑区干燥。两组的 PED 最大高度均显著减少。在 7 例初次治疗的眼中,PED 完全吸收;从 24 周开始,PED 水平最大直径也略有增加。5.4%的病例发生 IOI。结论:brolucizumab 具有很强的干燥作用,能改善功能,促进液体吸收,明显改善 PED 形态,尤其对初次治疗的患者。这些结果结合治疗间隔的延长,使 brolucizumab 成为 nAMD 的有效治疗策略。