Abstract
Background: The purpose of this study was to describe early changes in the morphology of pigment epithelium detachments (PED) after an intravitreal injection of Brolucizumab into eyes with macular neovascularization secondary to exudative age-related macular degeneration (e-AMD). Method: We included twelve eyes of 12 patients with PED secondary to e-AMD which were not responding to prior anti-VEGF treatments. An ophthalmic examination and an assessment of PED-horizontal maximal diameter (PED-HMD), PED-maximum high (PED-MH) and macular neovascularization (MNV) flow area (MNV-FA) by the means of structural optical coherence tomography (OCT) and OCT Angiography (OCT-A) were performed at baseline, as well as 1, 7, 14 and 30 days after the injection. Results: The mean age of the population of study was 78.4 (SD ± 4.8). The mean number of previous Ranibizumab or Aflibercept injections was 13 (SD ± 8). At the last follow-up visit, the PED-HMD did not significantly change (p = 0.16; F(DF:1.94, 20,85) = 1.9), the PED-MH showed a significant reduction [p = 0.01; F(DF:1.31, 14.13) = 6.84.] and the MNV-FA did not significantly differ (p = 0.1; F(1.97, 21.67) = 2.54) from baseline. No signs of ocular inflammation were observed during follow-up. Conclusions: A single Brolucizumab injection was able to determine the short-term effects on PEDs’ anatomical features of eyes with an unresponsive e-AMD.
Highlights
By using structural optical coherence tomography (OCT) and OCT Angiography (OCT-A) imaging in this study, we aimed to assess the early changes in pigment epithelium detachment morphology after intravitreal injection of Brolucizumab into eyes with macular neovascularization (MNV)
Exclusion criteria were the concomitant presence of ophthalmological diseases potentially able to confound the interpretation of images, the lack of high-quality images and exudation regression following prior anti-vascular endothelial growth factor (VEGF) treatments
In cases of pigment epithelium detachments (PED) with hyporeflective contents not allowing for a clear visualization of the MNV, we considered the value of the MNV-flow area to be “0”
Summary
Over the age of 75, the risk of developing early and late AMD is 25% and 8%, respectively [3]. It was not a long time ago when the first anti-vascular endothelial growth factor (VEGF) drug received FDA approval for the treatment of e-AMD, and many steps forward have been made ever since [4]. The purpose of this study was to describe early changes in the morphology of pigment epithelium detachments (PED) after an intravitreal injection of Brolucizumab into eyes with macular neovascularization secondary to exudative age-related macular degeneration (e-AMD). Method: We included twelve eyes of 12 patients with PED secondary to e-AMD which were not responding to prior anti-VEGF treatments. Conclusions: A single Brolucizumab injection was able to determine the short-term effects on PEDs’ anatomical features of eyes with an unresponsive e-AMD
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