Brolucizumab in Pretreated Neovascular Age-Related Macular Degeneration: Case Series, Systematic Review, and Meta-Analysis

Brolucizumab in Pretreated Neovascular Age-Related Macular Degeneration: Case Series, Systematic Review, and Meta-Analysis

Blog Article

Background: Recalcitrant neovascular age-related macular degeneration (rnAMD) despite intensive intravitreal anti-neovascular endothelial growth factor (VEGF) treatment, can be handled by switching to another anti-VEGF agent.This first systematic review and meta-analysis presents long-term data after switching from another anti-VEGF agent to brolucizumab.Methods: Retrospective case series over two years of patients switched to brolucizumab, and a systematic review and meta-analysis of peer-reviewed studies presenting patients switched to brolucizumab.Weighted mean differences based on the random-effects models were calculated for best-corrected visual acuity (BCVA) and central subfield Battery Disconnect thickness (CST).

Results: The systematic review draws on 1200 eyes switched to brolucizumab.The meta-analysis showed a clinically irrelevant decrease in BCVA after one and two months, together with significant decreases in CST for up to one year after the switch but lacking power over 2 years.Of twelve eyes (twelve patients) in our case series, five continued treatment for two years without experiencing significant changes.Conclusions: After switch to brolucizumab, a Anti-Fatigue Mats significant morphological improvement with CST reduction was shown in eyes with rnAMD.

The small worsening of BCVA may be owing to the chronically active nature of rnAMD.Brolucizumab thus remains a treatment option in rnAMD despite its potential side effects.