Subfoveal choroidal thickness after brolucizumab therapy for neovascular age-related macular degeneration: a short-term multicenter study
Subfoveal choroidal thickness after brolucizumab therapy for neovascular age-related macular degeneration: a short-term multicenter study
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DOI：
10.1007/s00417-021-05517-1
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发表时间：
2022-01-16
影响因子：
2.7
通讯作者：
Koizumi, Hideki
中科院分区：
文献类型：
--
作者：
Tamashiro, Tamaki;Tanaka, Koji;Koizumi, Hideki
背景/目的抗血管内皮生长因子（VEGF）治疗后脉络膜厚度的观察对于新生血管性年龄相关性黄斑变性（AMD）的理想治疗可能很重要。本研究调查了患有新生血管性 AMD 的眼睛在玻璃体内注射 brolucizumab 负荷剂量期间黄斑中心凹下脉络膜厚度 (SCT) 的变化。 方法 本研究纳入了日本五所大学医院的 72 名新生血管性 AMD 患者的 73 只眼睛。所有 73 只眼睛在基线、第 1 个月和第 2 个月均接受三个月一次 6.0 mg 的 brolucizumab 玻璃体内注射。采用光学相干断层扫描评估3个月时的SCT。结果73只眼被分为初治组（43只眼）和从其他抗VEGF治疗转换而来的转换组（30只眼）。玻璃体内注射 3 次 brolucizumab 后，初治组的 SCT 从基线时的 236.5 +/- 98.8 μm 显着下降至 3 个月时的 200.4 +/- 98.3 μm（基线百分比 84.7%，P < 0.001）。在转换组中，SCT 也从基线时的 229.0 +/- 113.2 μm 显着下降至 3 个月时的 216.9 +/- 110.2 μm（基线百分比 94.7%，P = 0.039），尽管与未接受治疗组相比下降幅度不那么明显。 结论 玻璃体内注射 brolucizumab 治疗新生血管性 AMD 显着降低了两组患者的 SCT。初治组和交换组。 Brolucizumab 可能会导致脉络膜发生显着的解剖学变化，特别是在未接受治疗的 AMD 眼中，可能比之前报道的其他抗 VEGF 药物更严重。
Background/purpose Observation of choroidal thickness after anti-vascular endothelial growth factor (VEGF) therapy may be important for the ideal management of neovascular age-related macular degeneration (AMD). This study investigated changes in subfoveal choroidal thickness (SCT) during loading doses of intravitreal injections of brolucizumab in eyes with neovascular AMD.Methods This study included 73 eyes of 72 patients with neovascular AMD at five university hospitals in Japan. All 73 eyes underwent three monthly 6.0 mg intravitreal injections of brolucizumab at baseline, 1 month, and 2 months. The SCT at 3 months was evaluated using optical coherence tomography.Results The 73 eyes were classified into the treatment-naive group (43 eyes) and the switched group (30 eyes) that were switched from other anti-VEGF treatments. After three intravitreal injections of brolucizumab, SCT significantly decreased from 236.5 +/- 98.8 mu m at baseline to 200.4 +/- 98.3 mu m at 3 months (percent of baseline 84.7%, P < 0.001) in the treatment-naive group. In the switched group, SCT also significantly decreased from 229.0 +/- 113.2 mu m at baseline to 216.9 +/- 110.2 mu m at 3 months (percent of baseline 94.7%, P= 0.039), although the decrease was not as marked compared to that of the treatment-naive group.Conclusion Intravitreal injections of brolucizumab for neovascular AMD significantly reduced the SCT in both the treatment-naive and switched groups. Brolucizumab may cause significant anatomic changes in the choroid, particularly in treatment-naive AMD eyes, possibly more than that previously reported for other anti-VEGF agents.