One-year outcomes of intravitreal brolucizumab injections in patients with polypoidal choroidal vasculopathy

Abstract

To evaluate the 1-year visual outcomes and anatomic responses of Japanese patients who received intravitreal brolucizumab (IVBr) injections for polypoidal choroidal vasculopathy (PCV). This was a retrospective study of 17 treatment-naïve eyes with PCV that were treated with IVBr. We evaluated the best-corrected visual acuity (BCVA), central macular thickness (CMT), central choroidal thickness (CCT) and number of injections for 1 year. The eradication of polypoidal lesions was also evaluated using by indocyanine green angiography during the 1-year follow-up. Non-infectious intraocular inflammation developed in two (11.8%) eyes; 15 eyes were assessed at the 1-year follow-up examination. The mean BCVA improved significantly from 0.28 at baseline to 0.13 (P < 0.05) at 1 year. The CMT and CCT decreased significantly after 1 year. The mean number of injections was 6.4 ± 0.13. The rate of complete resolution of polypoidal lesions at 1 year was 93.3%. A dry macula was achieved in 13 eyes (86.6%) after the loading phase and in 11 eyes (73.3%) at 1 year. The IVBr injections appeared to be effective for improving both functional and anatomic outcomes in Japanese patients with PCV, with a high regression rate of polypoidal lesions.

Polypoidal Choroidal Vasculopathy: Updates on Risk Factors, Diagnosis, and Treatments

“…An analysis of a subgroup of Japanese patients with PCV from the HAWK study reported comparable anatomic and functional outcomes with 8-weekly or 12-weekly injections of brolucizumab, compared with eyes without PCV 105. This study reported the 76% probability of maintaining injections at 12-week interval after the loading phase through 48 weeks, which was similar to the result of a recently published retrospective case series of brolucizumab for PCV 106…”

“…Another retrospective case series in Japan reported the rate of complete closure of the polypoidal lesions at 93.3% with 3 monthly injections of brolucizumab followed by either fixed 8-week or 12-week injections for 1 year. Both visual and anatomical outcomes were also significantly improved with brolucizumab injections 106…”

“…105 This study reported the 76% probability of maintaining injections at 12-week interval after the loading phase through 48 weeks, which was similar to the result of a recently published retrospective case series of brolucizumab for PCV. 106 In addition, 2 retrospective, multicentered case series on brolucizumab for MNV including PCV conducted in Japan found that after 3 monthly loading injections, complete regression of polypoidal lesions was found in ~80% (78.9% and 82%) of eyes with PCV. 107,108 Another retrospective case series in Japan reported the rate of complete closure of the polypoidal lesions at 93.3% with 3 monthly injections of brolucizumab followed by either fixed 8-week or 12-week injections for 1 year.…”

“…Both visual and anatomical outcomes were also significantly improved with brolucizumab injections. 106 Noninfectious intraocular inflammation (IOI) was found from 6.8% to 22.1% of eyes with nAMD or PCV treated with brolucizumab in recent studies of Japanese eyes. Some of these studies contained only eyes with PCV.…”

The Treatment Patterns with Brolucizumab in Germany (REALIZE) Study: A Retrospective Cohort Study Based on Longitudinal Prescription Data

“…Our results therefore add further evidence that brolucizumab can extend treatment intervals, thus reducing the number of injections which lowers treatment burden for patients with nAMD [2][3][4][5][6] and demonstrates that a switch to brolucizumab may be an effective treatment option. Recalcitrant fluid, particularly in outer compartments such as the subretinal and sub-RPE (retinal pigment epithelium) space with fluid alterations can be better addressed with brolucizumab [11,13,14,[24][25][26] which makes it a useful addition to the armamentarium of choices in treatment of nAMD. Strengths of the study lie in the strong representativity and large coverage of the database for the German patient population, the large sample size and length of follow-up time.…”