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Successful treatment of retinal pigment epithelial detachment associated with exudative age-related macular degeneration using brolucizumab Keishi Nishiguchi 1 , Manabu Yamamoto 1 , Akika Kyo 1 , Takeya Kono 1 , Kumiko Hirayama 1 , Norihiko Misawa 1 , Shigeru Honda 1 1Osaka Metropolitan University, Graduate School of Medicine, Ophthalmology and Visual Science pp.465-471
Published Date 2025/4/15
DOI https://doi.org/10.11477/mf.037055790790040465
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Abstract Purpose:To report six cases of previously refractory retinal pigment epithelial detachment(PED)associated with exudative age-related macular degeneration(AMD)that responded positively to intravitreal brolucizumab injections(IVBr).

Methods:This study included six eyes from six patients(three males and three females)with exudative AMD and refractory PED. These patients were treated with IVBr between June 2022 and February 2024 at the Department of Ophthalmology, Osaka Public University. All patients underwent IVBr using the treat-and-extend(TAE)method, starting at the interval of the previous treatment in patients switching from anti-vascular endothelial growth factor(anti-VEGF)therapy, and at 5-week intervals in all other cases. Corrected visual acuity(converted to logMAR), central macular thickness(CMT), and central choroidal thickness(CCT)were compared before the switch to IVBr and at the final follow-up visit.

Results:The mean observation period following the IVBr initiation was 15.3 months. Prior treatment included other anti-VEGF drugs, photodynamic therapy, and selective pigment epithelial laser therapy, with a mean time from initial treatment to switch of 97.5 months. After switching to IVBr, the mean visual acuity improved from 0.48 to 0.45 at the final follow-up visit, mean CMT from 154 to 112 μm, mean CCT from 209 to 165 μm, and mean PED height from 394 to 0 μm, indicating a significant reduction in CMT, CCT, and PED, respectively(p=0.02, 0.03, and 0.01). PED resolution was achieved within varying timeframes across the six eyes:one eye resolved within one month, another within three months, a third within six months, and the remaining three eyes within twelve months.

Conclusion:IVBr were effective in treating PED associated with exudative AMD in cases previously resistant to existing therapy.


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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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