Short-term morpho-functional changes in previously treated neovascular AMD eyes switched to brolucizumab

Abstract Purpose: To explore the morpho-functional fluctuations in eyes treated for nAMD when switched from aflibercept or ranibizumab to brolucizumab.Methods: 31 eyes of 31 patients with nAMD with type 1 MNV were included. All patients were imaged using the SD-OCT. The OCT acquisition was performed at the following visits:(I)1 month before the intravitreal injection of aflibercept or ranibizumab (T1),(I) 1 month after T1 and at the time of switch to brolucizumab injection (T2), and 1 month after the latter procedure (T3). The main outcome measures were:(1) Central macular thickness (CMT),(2) choroidal vascularity index (CVI) and,(3) subfoveal choroidal thickness (CT). Results: CMT analysis showed fluctuations at 3 times. In detail,T2 displayed a thicker CMT in comparison to T1, although not statistically significant (p= 0.12). Contrariwise,T3 showed a thinner CMT in comparison to T2 (p= 0.002). Analyzing CVI among the three different times, the LCA and TCA showed significantly different values before and after switching to brolucizumab. T2 showed a significant reduction in both vessel lumen and total area compared to T1 (p= 0.032 and p = 0.046, respectively).Moreover, T3 showed a greater value of both LCA and TCA in comparison to T2 (p= 0.008 and p = 0.01, respectively).CT did not show significant differences at each time (P>0.05)Conclusions: Our results reported early experiences on morpho-functional fluctuations in patients with nAMD switched to brolucizumab. The anatomical impact of brolucizumab administration appears to result in more effective resolution of SRF and IRF, in association with choroidal vascular swelling.