Brolucizumab related intraocular inflammation in Recalcitrant Wet Age-Related Macular Degeneration: Predictive Biomarkers from a Real-World study
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Yes
Purpose
Incidence of intraocular inflammation (IOI) is known higher in brolucizumab (Beovu, Norvatis®) treated neovascular age-related macular degeneration (nAMD) patients. Our paper assesses the clinical features and biomarkers of brolucizumab related IOI for better future treatment stratification.
Methods
A retrospective, multicenter cohort study of 93 switched nAMD patients (109 eyes) who received 2-monthly Beovu injection.
Results
17 eyes (15.6%) from 14 patients demonstrated IOI (6.4% anterior uveitis (AU), 4.6% intermediate uveitis (IU), and 4.6% panuveitis ± retinal vasculitis (RV)). There were 11.8% asymptomatic. Floater was specific to panuveitis ± RV eyes. The median manifestation of IOI was 26 days post injection and 82.4% elicited before the third injection. Three patients decided for further Beovu injections after IOI seamlessly. The multivariant risk factor analysis indicated that number of prior intravitreal aflibercept (hazard ratio (HR)= 1.33, P = 0.014) and total anti-VEGF injections (HR= 1.51, P = 0.007) one-year preceding Beovu were significant for IOI development. Baseline nAMD type, choroidal neovascularization size, and whether the development of retinal pigment epithelial and outer retinal atrophy or not were irrelevant to IOI.
Conclusion
Our findings suggest that meticulous review of patients within one month after each injection of their initial treatments is necessary. Use of Brolucizumab in recalcitrant nAMD patients who had multiple prior intravitreal anti-VEGF injections may need particular attention for IOI.
Conflict of interest
No
1
Last name
CHEN
Initials of first name(s)
YH
Department
Department of ophthalmology, Chang Gung Memorial Hospital, Linkou main branch
City
Taoyuan
Country
Taiwan
2
Last name
Hwang
Initials of first name(s)
YH
Department
Department of ophthalmology, Chang Gung Memorial Hospital, Linkou main branch
City
Taoyuan
Country
Taiwan
3
Last name
We
Initials of first name(s)
WC
Department
Department of ophthalmology, Chang Gung Memorial Hospital, Linkou main branch
City
Taoyuan
Country
Taiwan
4
Last name
Liu
Initials of first name(s)
L
Department
Department of ophthalmology, Chang Gung Memorial Hospital, Linkou main branch
City
Taoyuan
Country
Taiwan
5
Last name
Chen
Initials of first name(s)
KJ
Department
Department of ophthalmology, Chang Gung Memorial Hospital, Linkou main branch
City
Taoyuan
Country
Taiwan
6
Last name
Chao
Initials of first name(s)
AN
Department
Department of ophthalmology, Chang Gung Memorial Hospital, Linkou main branch
City
Taoyuan
Country
Taiwan
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