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

  • Retinal Disorders
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Abstract

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-naïve 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 µm at baseline to 200.4 ± 98.3 µm at 3 months (percent of baseline 84.7%, P < 0.001) in the treatment-naïve group. In the switched group, SCT also significantly decreased from 229.0 ± 113.2 μm at baseline to 216.9 ± 110.2 μm at 3 months (percent of baseline 94.7%, P = 0.039), although the decrease was not as marked compared to that of the treatment-naïve group.

Conclusion

Intravitreal injections of brolucizumab for neovascular AMD significantly reduced the SCT in both the treatment-naïve and switched groups. Brolucizumab may cause significant anatomic changes in the choroid, particularly in treatment-naïve AMD eyes, possibly more than that previously reported for other anti-VEGF agents.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Japan AMD Research Consortium (JARC): Tamaki Tamashiro, MD, Sorako Wakugawa, MD, Nobuhiro Terao, MD, PhD, and Hideki Koizumi, MD, PhD (Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Japan); Koji Tanaka, MD, PhD, Hajime Onoe, MD, Yu Wakatsuki, MD, PhD, and Ryusaburo Mori, MD, PhD (Department of Ophthalmology, Nihon University School of Medicine, Japan). Kanako Itagaki, MD, Akihito Kasai, MD, Masashi Ogasawara, MD, Hiroaki Shintake, MD, and Yukinori Sugano, MD, PhD, and Tetsuju Sekiryu, MD, PhD (Department of Ophthalmology, Fukushima Medical University, Japan). Makiko Nakayama, MD, PhD, Akiko Yamamoto, MD, PhD, Keiko Kataoka, MD, PhD, and Annabelle A. Okada, MD, PhD (Department of Ophthalmology, Kyorin University School of Medicine, Japan); Ichiro Maruko, MD, PhD, Taiji Hasegawa, MD, PhD, Takahiko Izumi, MD, PhD, Moeko Kawai, MD, and Ruka Maruko, MD, PhD, and Tomohiro Iida, MD, PhD (Department of Ophthalmology, Tokyo Women’s Medical University, Japan).

Funding

This work was supported by JSPS KAKENHI Grant Number JP21K09746 (Prof. Koizumi). Japan Society for the Promotion of Science, JP21K09746,Hideki Koizumi

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Authors and Affiliations

  1. Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan

    Tamaki Tamashiro, Sorako Wakugawa, Nobuhiro Terao & Hideki Koizumi

  2. Department of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan

    Koji Tanaka, Hajime Onoe, Yu Wakatsuki & Ryusaburo Mori

  3. Department of Ophthalmology, Fukushima Medical University, Fukushima, Japan

    Kanako Itagaki, Masashi Ogasawara, Yukinori Sugano & Tetsuju Sekiryu

  4. Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan

    Makiko Nakayama, Akiko Yamamoto, Keiko Kataoka & Annabelle A. Okada

  5. Department of Ophthalmology, Tokyo Women’s Medical University, Tokyo, Japan

    Ichiro Maruko, Takahiko Izumi, Moeko Kawai & Tomohiro Iida

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for the Japan AMD Research Consortium (JARC)

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Correspondence to Hideki Koizumi.

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Ethics approval

The study protocol was approved by the institutional review board of each university and was conducted in accordance with the guidelines of the Declaration of Helsinki.

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Written informed consent was obtained from all the patients included in this study.

Conflict of interest

Dr. Tamashiro reported personal fees from Alcon, Novartis, and Senju outside the submitted work. Dr. Tanaka reported personal fees from Alcon, Bayer, Novartis, Santen, and Senju outside the submitted work. Dr. Itagaki reported personal fees from Bayer and Novartis outside the submitted work. Dr. Nakayama has nothing to disclose. Dr. Maruko reported grants from JSPS KAKENHI (Grant Number JP20K09781); personal fees from Alcon, Bayer, Canon, Nidek, Novartis, Santen, Senju, and Topcon outside the submitted work. Dr. Wakugawa reported personal fees from Senju and Novartis outside the submitted work. Dr. Terao reported personal fees from Bayer, Nidek, Novartis, Senju, Santen, and Topcon outside the submitted work. Dr. Onoe reported personal fees from AMO and Novartis outside the submitted work. Dr. Wakatsuiki reported personal fees from Bayer outside the submitted work. Dr. Ogasawara has nothing to disclose. Dr. Sugano has nothing to disclose. Dr. Yamamoto reported personal fees from Alcon, Bayer, Novartis, Otsuka, and Santen outside the submitted work. Dr. Kataoka reported personal fees from Bayer, Novartis, Santen, and Senju outside the submitted work. Dr. Izumi reported personal fees from Senju and Topcon outside the submitted work. Dr. Kawai has nothing to disclose. Dr. Mori reported personal fees from Novartis, Bayer, Senju, Santen, Bausch & Lomb, JFC, Nikon, and Acula outside the submitted work. Dr. Sekiryu reported personal fees from Novartis, Bayer, Senju, Santen, Kowa, Allergan, and Chugai outside the submitted work. Dr. Okada reported consulting fees from Astellas, Bayer, Biocon Biologics, Daiichi Sankyo, HOYA, Kowa, and Novartis; personal support from Abbvie, Alcon, Bayer, Mitsubishi Tanabe, Novartis, Pfizer, Santen, and Senju outside the submitted work. Dr. Iida reported consulting fees from Bayer and Chugai; personal fees from AMO, Alcon, Bayer, Canon, HOYA, JFC, Kowa, Nikon, Nidek, Novartis, Otsuka, Pfizer, Santen, Senju, and Topcon outside the submitted work. Dr. Koizumi reported grants from JSPS KAKENHI (Grant Number JP21K09746); personal fees from Novartis, Alcon, Bayer, Canon, Senju, Santen, Kowa, HOYA, AMO, Otsuka, Pfizer, Allergan, Bausch & Lomb, JFC, Nidek, Topcon, Abbvie, TOMEY, Sumitomo Dainippon Pharma, Chugai, and SANOFI outside the submitted work.

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Tamashiro, T., Tanaka, K., Itagaki, K. et al. Subfoveal choroidal thickness after brolucizumab therapy for neovascular age-related macular degeneration: a short-term multicenter study. Graefes Arch Clin Exp Ophthalmol 260, 1857–1865 (2022). https://doi.org/10.1007/s00417-021-05517-1

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