Outcomes of Re-Switching Anti-vascular Endothelial Growth Factor After Brolucizumab-Associated Inflammation in Age-related macular degeneration.

Purpose: To investigate the anatomical and functional outcomes in cases of re-switching to previous anti-vascular endothelial growth factor (VEGF) agents due to intraocular inflammation (IOI) following a switch to brolucizumab in neovascular age-related macular degeneration (nAMD).

Methods: This study included patients with nAMD who switched to brolucizumab and discontinued brolucizumab treatment due to IOI, with a follow-up duration of at least 6 months before and after brolucizumab treatment period. Changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), central choroidal thickness (CCT), and retinal fluid on optical coherence tomography were evaluated.

Results: A total of 16 eyes from 16 patients were reviewed. 12.5% of patients achieved complete fluid resolution before brolucizumab treatment, which increased to 93.8% during brolucizumab therapy. However, after switching back to other anti-VEGF agents, the proportion of patients with dry macula decreased to 37.5%. There were no statistically significant changes in BCVA, CMT, or CCT throughout the study period.

Conclusions: In cases where brolucizumab treatment was discontinued due to IOI and switched back to other anti-VEGF agents, the anatomical response was insufficient, indicating the need for alternative treatment options.