Clinical features and associated factors of intraocular inflammation following intravitreal brolucizumab as switching therapy for neovascular age-related macular degeneration
Clinical features and associated factors of intraocular inflammation following intravitreal brolucizumab as switching therapy for neovascular age-related macular degeneration
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玻璃体内注射 brolucizumab 转换治疗新生血管性年龄相关性黄斑变性后眼内炎症的临床特征和相关因素
DOI：
10.1007/s00417-023-06036-x
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Nakamura Makoto
中科院分区：
文献类型：
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作者：
Sotani Rei;Matsumiya Wataru;Kim Kyung Woo;Miki Akiko;Yasuda Eriko;Maeda Yoshifumi;Hara Rumiko;Kusuhara Sentaro;Nakamura Makoto
目的探讨新生血管性老年性黄斑变性(NAMD)患者玻璃体内注射溴卢珠单抗(IVBR)后眼内炎症(IOI)的临床特点及相关因素。评价IVBR术后IOI的临床表现和术后5个月最佳矫正视力(BCVA)的变化。评估IOI与基线因素(年龄、性别、BCVA、高血压和/或眼底动脉硬化改变、视网膜下高反射物质[SHRM]和黄斑萎缩)之间的关系。结果在87只眼中，18只眼(20.6%)发生IOI，2只眼(2.3%)发生视网膜动脉阻塞。IOI组后葡萄膜炎或泛葡萄膜炎9例(50%)。首次使用IVBR至IOI的平均时间为2个月。5个月时IOI眼的对数平均屈光度变化(0.09 ± 0.22)明显低于非IOI眼( − 0.01 ± 0.15，P= 0.03)。IOI组和非IOI组黄斑萎缩分别为8例(44.4%)和7例(10.1%)，SHRM分别为11例(61.1%)和13例(18.8%)。SHRM和黄斑萎缩与IOI显著相关(分别为P= 0.0008和P= 0.002)。结论在非老年性AMD的IVBR治疗中，考虑到发生IOI的风险增加，应更加仔细地观察有SHRM和/或黄斑萎缩的眼，这与BCVA增加有关。
PurposeThe aim of this study is to explore the clinical features and associated factors of intraocular inflammation (IOI) following intravitreal brolucizumab (IVBr) administration for neovascular age-related macular degeneration (nAMD).MethodsThis retrospective study included 87 eyes from 87 Japanese patients with nAMD who were followed up for 5 months after the initial administration of IVBr as switching therapy. Clinical pictures of IOI post-IVBr and changes in best corrected visual acuity (BCVA) at 5 months were evaluated between eyes with and without IOI (non-IOI). The association between IOI and baseline factors (age, sex, BCVA, hypertension, and/or arteriosclerotic changes in the fundus, subretinal hyperreflective material [SHRM], and macular atrophy) was evaluated.ResultsOf the 87 eyes, 18 (20.6%) developed IOI and 2 (2.3%) developed retinal artery occlusion. There were 9 (50%) cases of posterior or pan-uveitis among eyes with IOI. The mean interval from initial IVBr administration to IOI was 2 months. The mean changes in logMAR BCVA at 5 months were significantly worse in IOI eyes than in non-IOI eyes (0.09 ± 0.22 vs. − 0.01 ± 0.15,P= 0.03). There were 8 (44.4%) and 7 (10.1%) cases of macular atrophy and 11 (61.1%) and 13 (18.8%) cases of SHRM in the IOI and non-IOI groups, respectively. SHRM and macular atrophy were significantly associated with IOI (P= 0.0008 andP= 0.002, respectively).ConclusionIn IVBr therapy for nAMD, eyes with SHRM and/or macular atrophy should be observed more meticulously, given the increased risk of developing IOI, which is associated with insufficient BCVA gain.