Short-term efficacy and Safety of Intravitreal Brolucizumab Injection for Treatment-naïve exudate Age-related Macular Degeneration; A Multicenter Study.

Abstract

To compare short-term efficacy and safety of intravitreal brolucizumab injection with aflibercept in treatment-naïve neovascular age-related macular degeneration (nAMD) patients. 59 eyes of 59 treatment-naïve nAMD patients in 3 ______________Hospitals were retrospectively reviewed. 27 patients underwent intravitreal brolucizumab injections and 32 received aflibercept. After monthly consecutive 3 injections, best-corrected visual acuity (BCVA), central macular thickness (CMT), dry macula achievement rate, and intraocular inflammation (IOI) incidence were compared. After loading phase treatment, BCVA was significantly increased from 0.48 ± 0.30 at baseline to 0.33 ± 0.21 at 3 months in the brolucizumab group (P = 0.002) and 0.40 ± 0.39 to 0.33 ± 0.36 in the aflibercept group (P = 0.007). But there was no significant difference in BCVA improvement at 3 months between the two groups. CMT was significantly decreased from 429.67 ± 250.59 µm at baseline to 210.67 ± 93.53 µm at 3 months in the brolucizumab group and from 346.69 ± 159.09 µm to 234.52 ± 83.42 µm in the aflibercept group (both p = 0.000). The amount of CMT reduction was significantly greater in the brolucizumab group after 3 months (p = 0.036). In typical AMD eyes, brolucizumab showed similar BCVA improvement but better CMT reduction at 3 months (p = 0.018). Dry macula achievement rate was not significantly different between the two groups. 1 IOI was observed in the brolucizumab group. Intravitreal injections of brolucizumab and aflibercept showed similar anatomical and functional outcomes. But CMT reduction was greater in the brolucizumab group. 1 IOI was identified, which was tolerable for topical agents. These results suggest that brolucizumab could be a novel first line treatment option for treating naïve nAMD patients.