Outcomes of Re-Switching Anti–Vascular Endothelial Growth Factor after Brolucizumab-Associated Inflammation in Age- Related Macular Degeneration
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Purpose: To investigate the anatomical and functional outcomes in cases of re-switching to previous anti–vascular endothelial growth factor (anti-VEGF) agents due to intraocular inflammation (IOI) following a switch to brolucizumab in neovascular age-related macular degeneration. Methods: This study included patients with neovascular age-related macular degeneration who switched to brolucizumab and discontinued brolucizumab treatment due to IOI, with a follow-up duration of at least 6 months before and after brolucizumab treatment period. Changes in best-corrected visual acuity, central macular thickness, central choroidal thickness, and retinal fluid on optical coherence tomography were evaluated. Results: A total of 16 eyes from 16 patients were reviewed. Two patients (12.5%) achieved complete fluid resolution before brolucizumab treatment, which increased to 15 (93.8%) during brolucizumab therapy. However, after switching back to other anti-VEGF agents, the proportion of patients with dry macula decreased to 37.5%. There were no statistically significant changes in best-corrected visual acuity, central macular thickness, central choroidal thickness throughout the study period. Conclusions: In cases where brolucizumab treatment was discontinued due to IOI and switched back to other anti-VEGF agents, the anatomical response was insufficient, indicating the need for alternative treatment options.
Abstract
Purpose: To investigate the anatomical and functional outcomes in cases of re-switching to previous anti–vascular endothelial growth factor (anti-VEGF) agents due to intraocular inflammation (IOI) following a switch to brolucizumab in neovascular age-related macular degeneration. Methods: This study included patients with neovascular age-related macular degeneration who switched to brolucizumab and discontinued brolucizumab treatment due to IOI, with a follow-up duration of at least 6 months before and after brolucizumab treatment period. Changes in best-corrected visual acuity, central macular thickness, central choroidal thickness, and retinal fluid on optical coherence tomography were evaluated. Results: A total of 16 eyes from 16 patients were reviewed. Two patients (12.5%) achieved complete fluid resolution before brolucizumab treatment, which increased to 15 (93.8%) during brolucizumab therapy. However, after switching back to other anti-VEGF agents, the proportion of patients with dry macula decreased to 37.5%. There were no statistically significant changes in best-corrected visual acuity, central macular thickness, central choroidal thickness throughout the study period. Conclusions: In cases where brolucizumab treatment was discontinued due to IOI and switched back to other anti-VEGF agents, the anatomical response was insufficient, indicating the need for alternative treatment options.