Comparative analysis of the anterior chamber changes after intravitreal injections of aflibercept and brolucizumab

Abstract

BACKGROUND: Currently, the information is insufficient about the effect of multiple intravitreal injections (IVI) of brolucizumab in comparison with aflibercept on the parameters of iridolenticular diaphragm.
 AIM: The aim of this study is using optical coherence tomography of the anterior segment (AS-OCT) to evaluate changes in the parameters of the anterior chamber in patients with multiple intravitreal injections of aflibercept and brolucizumab in the treatment of the neovascular form of age-related macular degeneration (nAMD).
 MATERIALS AND METHODS: In total, 60 patients (60 eyes) were included into the study. The follow-up period duration was 12 months. Patients were divided into 2 groups: group 1 — 30 patients receiving intravitreal injections of aflibercept, group 2 — 30 patients receiving intravitreal injections of brolucizumab. Using a Revo NX tomograph, AS-OCT was performed, the depth of the anterior chamber and the dimensions of the anterior chamber angle were examined. The measurement was performed before intravitreal injections, one month after the first, one month after the third intravitreal injections, and one year after treatment.
 RESULTS: In both groups, a shift of the iridolenticular diaphragm was noted according to AS-OCT data — a significant decrease in depth of the anterior chamber, anterior chamber angle parameters before treatment and after 4 months of treatment, as well as after a year of treatment. In group 1, in contrast to group 2, a greater number of intravitreal injections led to a greater decrease in the depth of the anterior chamber (rxy = 0.415, p = 0.02) and to a greater narrowing of the anterior chamber angle on the nasal and temporal sides (rxy = 0.37, p = 0.049 and rxy = 0.424, p = 0.02, respectively).
 CONCLUSIONS: For the first time, changes of the anterior chamber of the eye were determined against the background of multiple intravitreal injections of aflibercept and brolucizumab in the treatment of the neovascular form of age-related macular degeneration using AS-OCT.