Abstract
Purpose :
To investigate clinical and anatomical factors associated with injection interval in refractory neovascular age-related macular degeneration (nAMD) patients who were switched to brolucizumab due to poor response to prior anti-vascular endothelial growth factor (anti-VEGF) treatment.
Methods :
Patients were classified into two groups based on the injection interval one year after switching to brolucizumab; (1) injection interval ≥ 12 weeks and (2) injection interval < 12 weeks. Retrospective review of electronic medical records and optical coherence tomography (OCT) images were done. Best-corrected visual acuity (BCVA), prior treatment interval (time between last prior anti-VEGF and first brolucizumab), prior number and type of injections, central retinal thickness (CRT), subfoveal choroidal thickness (SFChT), type of choroidal neovascularization (CNV), and the presence of subretinal hyperreflective material (SHRM) were compared between the two groups.
Results :
Forty eyes of 40 patients were included in the study, with 24 and 16 eyes were in groups 1 and 2, respectively. Patients with interval < 12 weeks showed larger number of prior injections (21.93 ± 8.30 vs 13.42 ± 9.44, p=0.005) and types of prior anti-VEGF (2.27 ± 0.80 vs 1.63 ± 0.77, p=0.028). Anatomically, the presence of SHRM was more frequent in this group (62.50% vs 29.17%, p=0.039). BCVA (0.41 ± 0.24 [group 1] vs 0.48 ± 0.29 [group 2] logMAR, p=0.383), prior treatment interval (9.92 ± 8.13 vs 9.87 ± 5.91 weeks, p=0.875), CRT (401.92 ± 143.69 vs 412.40 ± 121.41 µm, p=0.638), SFChT (269.63 ± 111.54 vs 240.47 ± 100.11 µm, p=0.399), ratio of different CNV types (type1/type2 19/5 vs 12/4, p=0.525) were not different between the two groups.
Conclusions :
When switching to brolucizumab in refractory nAMD patients, a higher burden of prior anti-VEGF treatments and the presence of SHRM on OCT may predict a reduced potential for extending the treatment interval.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.