"Real world outcomes of intravitreal brolucizumab for persistent diabetic macular edema".

Aim: Chronic Persistent Diabetic Macular Edema can be a clinical challenge. The aim of this study is to assess the outcomes of intravitreal brolucizumab 6 mg/0.05 ml for persistent diabetic macular edema (P-DME) in a real-world clinical setting.

Methods: A prospective interventional trial of consecutive patients with P-DME was conducted at a tertiary care center in India. P-DME was defined as edema persisting despite more than three intravitreal anti-VEGF injections or despite a combination of anti-VEGFs, intravitreal steroids and/or laser photocoagulation. The change in visual acuity (VA), central retinal thickness (CRT) and any incidences of adverse effects were analyzed.

Results: 19 eyes of 13 patients received a mean of 3.3 injections at a mean interval of 11.1 weeks. The median VA improved from 0.40 logMAR (20/50) to 0.35 logMAR (20/44) after a mean period of 13 weeks after the last injection, which was statistically significant (p = 0.004). The CRT reduced from 517 microns to 237 microns (p = 0.001). One patient had an episode of intraocular inflammation, which was treated successfully with topical steroids. The same patient again received brolucizumab with no recurrent inflammation.

Conclusions: Intravitreal brolucizumab helped improve visual acuity in patients with P-DME and achieved a reduction of 54.1% in the CRT at a longer mean reinjection interval. The rate of intraocular inflammation was 5.2% without any permanent visual impairment.