An objective indicator of inflammation in real practice of anti-VEGF treatment of patients with wet age-related macular degeneration

Abstract

PURPOSE

To study the level of intraocular inflammation by laser flare photometry in patients with the wet age-related macular degeneration and anti-VEGF treatment in real practice.

SETTING / VENUE

Open-label comparative prospective interventional study was conducted in The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine, Odesa, Ukraine.

METHODS

Inclusion criteria: only primary, untreated patients with the exudative form of age-related macular degeneration, who are indicated for anti-VEGF therapy, participated in the study. Exclusion criteria: any intraocular surgery including cataract or glaucoma surgery; history of any kind of intraocular inflammation. Treatment: the first group of patients underwent intravitreal administration of 2 mg (0.05 ml) of aflibercept, in the second group, 6 mg (0.05 ml) of brolucizumab according to fixed schedule. The primary point of the study: the dynamics of the laser flare photometry indicator of inflammation during 6 months of observation. The secondary point of the study: the dynamics of the median BCVA and the thickness of the central retina in the 6 months of observation compared to the baseline characteristics.

RESULTS

20 patients (23 eyes) were included in the study. The aflibercept group included 12 patients (14 eyes). The brolucizumab group included 8 patients (9 eyes). The median objective indicator of inflammation at baseline in the aflibercept group was 6.3 ph/ms (from 2 ph/ms to 17.3 ph/ms), after 6 months it was 4.5 ph/ms (from 2.7 ph/ms to 6.9 ph/ms), p=0.5. In the brolucizumab group, the median objective indicator of inflammation at baseline was 6.95 ph/ms (from 4.7 ph/ms to 19 ph/ms), after 6 months it was 7.1 ph/ms (from 5 ph/ms to 9.2 ph/ms), p=0.4. During the entire observation period, there were no statistically significant changes in the laser flare photometry indicator in the two groups. The median inflammation indicator at the beginning and at 6 months did not differ statistically significantly between groups p=0.7 and p=0.2 respectively.

CONCLUSIONS

Intravitreal administration of aflibercept and brolucizumab in primary patients with the wet age-related macular degeneration does not lead to an increase of laser flare photometry indicator in 6 months, in the fixed regimen