The first experience with brolucizumab for neovascular age-related macular degeneration
Aim: to assess the efficacy and safety of brolucizumab in Russian patients with neovascular age-related macular degeneration (nAMD). Patients and Methods: this study enrolled 47 patients with nAMD divided into two groups. Group 1 included 13 treatment-naive patients/13 eyes (12 men and 1 woman, mean age 72.4±9.5 years, mean best-corrected visual acuity (BCVA) 0.43±0.32). Group 2 included 34 patients having active nAMD despite ongoing treatment/34 eyes (25 men and 9 women, mean age 74.1±8.0 years, mean BCVA 0.46±0.25). All patients received at least two intravitreal injections of brolucizumab (in total, 137 injections) with a 1-month interval. Patients were examined one month after the 2nd injections. BCVA, central macular thickness (CMT), macular volume (MV), sub/intraretinal fluid, and adverse events were evaluated. Results: in group 1, a significant increase in BCVA from 34.9±6.6 letters to 44.1±4.2 letters (p=0.02) was reported. Meanwhile, in group 2, BCVA remained unchanged (35.0±3.5 letters before treatment vs. 33.8±3.7 letters after treatment, p>005). In group 1, CMT and MV significantly reduced, while in group 2, only MV significantly reduced (p<0.05). A significant reduction in the cumulative rate of sub/ intraretinal fluid was detected in both groups (p<0.05). Conclusions: treatment-naive patients who received brolucizumab demonstrated a significant improvement of anatomical and functional parameters. Meanwhile, patients with active nAMD despite ongoing treatment who received brolucizumab demonstrated a significant reduction in disease activity and tendency to the improvement of anatomical (but not functional) parameters.