Efficacy of Intravitreal Brolucizumab Switch in Pachychoroid Neovasculopathy.

IF 3.2 3区 医学 Q2 OPHTHALMOLOGY
Nicolò Ribarich, Marco Battista, Lisa Checchin, Riccardo Sacconi, Francesco Bandello, Giuseppe Querques
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引用次数: 0

Abstract

Introduction: This study aimed to evaluate the anatomical and functional outcomes of switching to intravitreally administered brolucizumab (Beovu®, Novartis) in patients affected by pachychoroid neovasculopathy (PNV) who were considered as non-responders to previous anti-vascular endothelial growth factor (anti-VEGF) therapies, defined as the persistence of intraretinal fluid (IRF), subretinal fluid (SRF), or subretinal hyper-reflective material (SHRM).

Methods: Twenty-three eyes of 21 patients with exudative PNV, who were switched to brolucizumab between April 2021 and December 2023, were retrospectively enrolled. All patients had previously received at least one injection of another anti-VEGF agent. Following the switch (baseline), patients received brolucizumab under a pro re nata regimen and were followed for 12 months. Best-corrected visual acuity (BCVA), central macular thickness (CMT), central choroidal thickness (CT), and height of IRF, SRF, SHRM, and pigment epithelial detachment (PED) were assessed at baseline and at the 12-month follow-up.

Results: At 12 months after the switch to brolucizumab (mean 5.26 injections), BCVA remained stable (20/50, 0.4 logMAR). However, significant anatomical improvements were observed, including a reduction in SRF (97-18 µm, p = 0.002), SHRM (75-0 µm, p = 0.008), and CT (379-337 µm, p < 0.001). Resolution of IRF was achieved in 70% of eyes and SHRM in 87%. A median of 2 brolucizumab injections were required to achieve fluid control (absence of both IRF and SRF). Notably, the number of injections needed for complete SRF resolution predicted final BCVA.

Conclusion: In our cohort of patients with PNV, switching to brolucizumab demonstrated a significant anatomical response, leading to a reduction in exudative features. While BCVA remained stable, the number of brolucizumab injections required to resolve SRF emerged as a predictor of final visual outcome, suggesting that an earlier switch in non-responders might optimize anatomical results. The safety profile of brolucizumab in this study was favourable, with no severe inflammatory adverse events reported.

玻璃体内Brolucizumab转换治疗厚脉络膜血管病的疗效。
本研究旨在评估厚脉管炎新血管病变(PNV)患者切换到玻璃体内给药brolucizumab (Beovu®,诺华公司)的解剖和功能结果,这些患者被认为对先前的抗血管内皮生长因子(anti-VEGF)治疗无反应,定义为视网膜内液(IRF),视网膜下液(SRF)或视网膜下超反射物质(SHRM)的持续存在。方法:在2021年4月至2023年12月期间切换到brolucizumab的21例渗出性PNV患者的23只眼睛进行回顾性研究。所有患者之前都至少接受过一次注射另一种抗vegf药物。切换(基线)后,患者在自然方案下接受brolucizumab治疗,并随访12个月。在基线和12个月的随访中评估最佳矫正视力(BCVA)、中央黄斑厚度(CMT)、中央脉络膜厚度(CT)、IRF、SRF、SHRM和色素上皮脱离(PED)的高度。结果:在改用brolucizumab(平均5.26次注射)12个月后,BCVA保持稳定(20/50,0.4 logMAR)。然而,观察到显著的解剖改善,包括SRF(97-18µm, p = 0.002), SHRM(75-0µm, p = 0.008)和CT(379-337µm, p)的降低。结论:在我们的PNV患者队列中,切换到brolucizumab显示出显著的解剖反应,导致渗出特征减少。虽然BCVA保持稳定,但解决SRF所需的brolucizumab注射次数成为最终视觉结果的预测因子,这表明无应答者的早期转换可能会优化解剖结果。在这项研究中,brolucizumab的安全性是有利的,没有严重的炎症不良事件的报道。
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来源期刊
Ophthalmology and Therapy
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. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of ophthalmic therapies. Open Access All articles published by Ophthalmology and Therapy are open access. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning authors will always have an editorial contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. Digital Features and Plain Language Summaries Ophthalmology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. For examples of digital features please visit our showcase page https://springerhealthcare.com/expertise/publishing-digital-features/ Publication Fees Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of €5250/$6000/£4300. The journal will consider fee discounts and waivers for developing countries and this is decided on a case by case basis. Peer Review Process Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials, and Letters which are generally reviewed by one member of the Editorial Board. Where reviewer recommendations are conflicted, the editorial board will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed). Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case-by-case basis and should be sent to the journal editor. Preprints We encourage posting of preprints of primary research manuscripts on preprint servers, authors’ or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals. Authors should disclose details of preprint posting during the submission process or at any other point during consideration in one of our journals. Once the manuscript is published, it is the author’s responsibility to ensure that the preprint record is updated with a publication reference, including the DOI and a URL link to the published version of the article on the journal website. Please follow the link for further information on preprint sharing: https://www.springer.com/gp/authors-editors/journal-author/journal-author-helpdesk/submission/1302#c16721550 Copyright Ophthalmology and Therapy''s content is published open access under the Creative Commons Attribution-Noncommercial License, which allows users to read, copy, distribute, and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited. The author assigns the exclusive right to any commercial use of the article to Springer. For more information about the Creative Commons Attribution-Noncommercial License, click here: http://creativecommons.org/licenses/by-nc/4.0. Contact For more information about the journal, including pre-submission enquiries, please contact christopher.vautrinot@springer.com.
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