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Sub-Tenon’s capsule triamcinolone acetonide injection to prevent brolucizumab-associated intraocular inflammation

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the efficacy of sub-Tenon’s capsule triamcinolone acetonide (STTA) injections for preventing development of intraocular inflammation (IOI) related to intravitreal injection (IVI) of brolucizumab for neovascular age-related macular degeneration (nAMD).

Methods

Consecutive patients with nAMD treated with brolucizumab IVIs were studied retrospectively. All eyes treated with brolucizumab in the clinic were switched from another anti-vascular endothelial growth factor agent. After the fourth case of IOI related to brolucizumab IVI, all eyes treated with brolucizumab received a STTA injection. The patients were divided into two groups: brolucizumab alone and brolucizumab combined with a STTA injection.

Results

Forty-four eyes (44 patients) treated with at least one brolucizumab IVI were studied: 14 eyes received brolucizumab IVI alone and 30 eyes received the combination therapy. IOI related to brolucizumab IVIs developed in four (28.6%) of 14 eyes in the brolucizumab group; IOI was severe in one eye, moderate in two eyes, and mild in one eye according to the HAWK and HARRIER trial definition; IOI did not develop in the 30 eyes that received combination therapy, the difference of which reached significance (p = 0.012). Regarding combination therapy, the intraocular pressure in three (10%) eyes increased to 22 to about 26 mmHg after the STTA injection and returned to normal range within 2 months without medication; no cataracts developed during this short mean follow-up period follow-up period of 7.1 ± 0.4 months.

Conclusion

The results indicated the possible preventative effect of a STTA injection on development of brolucizumab-associated IOI.

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Authors and Affiliations

  1. Hikichi Eye Clinic, Kita-7 Nishi-5 7-1 Kita-Sky-Building 14 Floor, Kita-ku, Sapporo, 060-0807, Japan

    Taiichi Hikichi

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  1. Taiichi Hikichi
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TH was involved in conception, design, acquisition of data, analysis, drafting, and revising the article.

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Correspondence to Taiichi Hikichi.

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This study was approved by the Institutional Review Board of the Sapporo Medical Association, Sapporo, Japan.

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Hikichi, T. Sub-Tenon’s capsule triamcinolone acetonide injection to prevent brolucizumab-associated intraocular inflammation. Graefes Arch Clin Exp Ophthalmol 260, 2529–2535 (2022). https://doi.org/10.1007/s00417-022-05611-y

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  • DOI: https://doi.org/10.1007/s00417-022-05611-y

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