Hoshino Junki, Matsumoto Hidetaka, Nakamura Kosuke, Akiyama Hideo
Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Jpn J Ophthalmol. 2025 Mar;69(2):221-229. doi: 10.1007/s10384-024-01146-3. Epub 2025 Jan 23.
To evaluate the treatment outcomes of switching to intravitreal brolucizumab (IVBr) for neovascular age-related macular degeneration (nAMD) which did not achieve a dry macula even with 4- or 8-week intervals of intravitreal faricimab (IVF).
Retrospective, interventional case series.
We retrospectively studied 33 eyes of 33 consecutive patients with nAMD who switched to IVBr from IVF, assessing best corrected visual acuity (BCVA), foveal thickness (FT), central choroidal thickness (CCT), and exudative status at baseline and after the switch. For patients that switched 4 weeks after the last IVF (4-week interval group), treatment outcomes were evaluated 4 weeks after the switch. For patients that switched 8 weeks after the last IVF (8-week interval group), treatment outcomes were evaluated after the first 8-week interval following the switch.
Thirty-one eyes had completed IVBr treatment up to the evaluation point after the switch. There were no significant changes in BCVA at baseline and after the switch in either group. FT and CCT significantly decreased after the switch compared with baseline in both groups. Moreover, in both groups, exudative changes disappeared or decreased in most cases after the switch. The dry macula rate after the switch was 37.5% and 34.8% in the 4-week and 8-week interval group, respectively. Although brolucizumab-related intraocular inflammation was observed in 3 eyes (9.1%) after the switch, it was ameliorated in response to steroid therapy.
Switching to IVBr for nAMD refractory to IVF was generally effective in improving exudative changes in the short term.
评估对于即使接受玻璃体内注射法西单抗（IVF）间隔4周或8周仍未实现黄斑干燥的新生血管性年龄相关性黄斑变性（nAMD）患者，转换为玻璃体内注射布罗珠单抗（IVBr）后的治疗效果。
回顾性、介入性病例系列研究。
我们回顾性研究了33例连续的从IVF转换为IVBr的nAMD患者的33只眼，评估基线时以及转换后最佳矫正视力（BCVA）、黄斑中心凹厚度（FT）、脉络膜中央厚度（CCT）和渗出状态。对于在最后一次IVF后4周转换的患者（4周间隔组），在转换后4周评估治疗效果。对于在最后一次IVF后8周转换的患者（8周间隔组），在转换后的第一个8周间隔后评估治疗效果。
至转换后的评估点，31只眼已完成IVBr治疗。两组在基线时和转换后BCVA均无显著变化。与基线相比，两组转换后FT和CCT均显著降低。此外，两组在转换后大多数病例中渗出性改变消失或减轻。4周和8周间隔组转换后的黄斑干燥率分别为37.5%和34.8%。尽管转换后3只眼（9.1%）观察到布罗珠单抗相关的眼内炎症，但经类固醇治疗后病情改善。
对于对IVF难治的nAMD患者转换为IVBr，通常在短期内改善渗出性改变方面是有效的。
