Subfoveal choroidal thickness after brolucizumab therapy for neovascular age-related macular degeneration: a short-term multicenter study

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.

Automated summary

This study investigated the changes in subfoveal choroidal thickness after intravitreal injections of brolucizumab in patients with neovascular age-related macular degeneration (AMD). The results showed that brolucizumab significantly reduced the choroidal thickness, especially in treatment-naive AMD patients.