Factors Affecting Disease Stability After Intravitreal Brolucizumab Injection for Refractory Neovascular Age-Related Macular Degeneration.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Ophthalmology and Therapy Pub Date : 2024-10-01 Epub Date: 2024-08-12 DOI:10.1007/s40123-024-01010-0

Yung-Hwi Kim, Tae Kyu Moon, Yong-Sok Ji

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引用次数: 0

Abstract

Introduction: The purpose of this study is to identify the factors affecting neovascular age-related macular degeneration (nAMD) disease stability after brolucizumab treatment.

Methods: We retrospectively analyzed the medical records of 31 patients (31 eyes) with recalcitrant nAMD who were switched to brolucizumab after conventional anti-vascular endothelial growth factor (VEGF) treatment. We divided patients into two groups by treatment extension (TE) period: group 1 with TE < 12 weeks (N = 16) and group 2 with TE ≥ 12 weeks (N = 15). We compared outcomes between the groups at 2, 4, 8, and 12 weeks, including morphological characteristics of choroidal neovascularization (CNV). Logistic regression analysis identified factors associated with TE ≥ 12 weeks.

Results: Group 2 had a significantly greater proportion of patients with dry macula (subretinal and intraretinal fluids absent) than group 1 (60 vs. 12.5%) at 2 weeks (P < 0.05). Best-corrected visual acuity (BCVA) and subfoveal choroidal thickness (SFCT) did not differ significantly between groups at all timepoints. Central subfield retinal thickness (CST) was significantly lower in group 2 at 2 (237.1 vs. 280.8 μm; P < 0.05), 4 (224.0 vs. 262.9 μm; P < 0.05), and 8 weeks (216.8 vs. 331.1 μm; P < 0.05). Group 2 had less vessel area (0.63 vs. 1.27 mm²; P < 0.05) and total vessel length (0.22 vs. 0.42 mm; P < 0.05). Choriocapillaris flow deficit (CCFd) was significantly lower in group 2 (42.7 vs. 48.2%; P < 0.05). Dry macula at 2 weeks (odds ratio [OR] = 8.3; P < 0.05) and a lower CCFd (OR = 0.73; P < 0.05) were associated with TE ≥ 12 weeks.

Conclusions: Early fluid-free status after switching to brolucizumab and choriocapillary function around CNV were prognostic factors for disease stability in nAMD refractory to anti-VEGF treatment.

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影响难治性新生血管性老年性黄斑变性静脉注射布卢珠单抗后病情稳定性的因素

简介：本研究的目的是确定影响新血管性年龄相关性黄斑变性（nAMD）治疗后病情稳定性的因素：本研究的目的是确定影响新血管性年龄相关性黄斑变性（nAMD）在接受brolucizumab治疗后病情稳定性的因素：我们回顾性分析了31例（31只眼）顽固性nAMD患者的病历，这些患者在接受常规抗血管内皮生长因子（VEGF）治疗后改用了brolucizumab。我们按治疗延长期（TE）将患者分为两组：第 1 组有 TE 结果：2 周时，第 2 组黄斑干性（视网膜下和视网膜内无液体）患者的比例（60% 对 12.5%）明显高于第 1 组（P 2；P 结论：第 1 组患者的黄斑干性（视网膜下和视网膜内无液体）比例明显高于第 2 组（P 3；P 4）：改用博路单抗后的早期无液状态和 CNV 周围的毛细血管功能是抗血管内皮生长因子治疗难治性 nAMD 疾病稳定的预后因素。

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来源期刊

Ophthalmology and Therapy OPHTHALMOLOGY-

CiteScore

4.20

自引率

3.00%

发文量

157

审稿时长

6 weeks

期刊介绍： Aims and Scope Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. 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