Clinical outcomes of switching to brolucizumab in refractory PCV treated with aflibercept

Abstract

Purpose : To investigate the efficacy and safety of brolucizumab in refractory PCV treated with aflibercept

Methods : A review of the medical records of patients with refractory PCV treated with aflibercept was conducted. Patients received at least three consecutive injections of aflibercept on a 4-8week dosing schedule before switching to brolucizumab. Changes of injection intervals, OCT and OCTA parameters including central macular thickness (CMT), subfoveal choroidal thickness (SFCT), polyp height, lesion area, flow density, and polyp regression rate were evaluated before and 6 months after switching.

Results : Thirty-two eyes of 32 patients with PCV who received brolucizumab injections as switch therapy were followed up to 6 months. After switching to brolucizumab, 53% eyes had dry macula and injection interval was extended from 5.4 ± 1.7 weeks to 10.8 ± 2.9 weeks. BCVA remained stable over 6 months (p=0.166). CMT and SFCT were reduced at 6 months after switching to brolucizumab (p=0.042 and p=0.023). Polyp regression was complete in 12.5% and partial in 62.5% of eyes. Largest polyp height and lesion size were significantly decreased (p=0.035 and p=0.010). However, no significant difference was found in terms of flow density after switching (p=0.145). Intraocular inflammation-related adverse events were not reported.

Conclusions : Brolucizumab could provide additional benefits in refractory PCV treated with aflibercept through reduction of leakage from polyps, BVN, and choroid.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.