Long term follow up of brolucizumab in macular neovascularization

Purpose :To evaluate functional and anatomical changes in type 1 and type 2 naive MNV patients treated with brolucizumab injections up to one year of treatment (week 48). Methods: 38 eyes of 38 patients with active MNV were enrolled at the Ophthalmology Clinic of the University "G. d'Annunzio", Chieti-Pescara, Italy. All patients were scheduled for brolucizumab intravitreal injections as per label, according to the standard HAWK and HARRIER trials guidelines. Enrolled patients underwent complete ophthalmic evaluation, including OCT and OCT angiography. All measurements were evaluated at baseline and then monthly up to week 48. The main outcome measures were: changes in best corrected visual acuity (BCVA); central macular thickness (CMT); sub-foveal choroidal thickness (SCT); pigment epithelial detachments (PEDs) presence and maximum height (PEDMH); intra-retinal fluid (IRF) presence, sub-foveal sub-retinal fluid (SSRF) presence and maximum height, macular atrophy area (MA) and neovascular membrane flow area in the slab extending from outer retina to choriocapillaris (ORCC flow). Results: CMT and BCVA significantly changed in both groups over time. ORCC flow and SCT significantly reduced in both groups over time. Atrophy areas increased from 0 to 0.17 mm(2) and from 0 to 0.23 mm(2) in type 1 MNV and type 2 MNV patients, respectively. PEDMH reduced in type 1 MNV from 138 mu m at T0 to 96 mu m at T5. Changes in fluids were noted, with sub-foveal sub-retinal fluid thickness (SSRFT) reduction and IRF changes in both groups. Conclusion Our one-year results of treatment confirm brolucizumab to be efficient and safe in both type 1 and type 2 MNV, proposing novel OCT parameters as possible biomarker of treatment.