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Kulikov A.N.

S.M. Kirov Military Medical Academy

Malafeeva A.Yu.

S.M. Kirov Military Medical Academy

Kalinicheva Y.A.

S.M. Kirov Military Medical Academy

Maltsev D.S.

S.M. Kirov Military Medical Academy

Zhalimova V.R.

S.M. Kirov Military Medical Academy

Vasiliev A.S.

S.M. Kirov Military Medical Academy

Short-term experience of intravitreal brolucizumab in treatment of diabetic macular edema

Authors:

Kulikov A.N., Malafeeva A.Yu., Kalinicheva Y.A., Maltsev D.S., Zhalimova V.R., Vasiliev A.S.

More about the authors

Journal: Russian Annals of Ophthalmology. 2023;139(1): 99‑105

DOI: 10.17116/oftalma202313901199

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To cite this article:

Kulikov AN, Malafeeva AYu, Kalinicheva YA, Maltsev DS, Zhalimova VR, Vasiliev AS. Short-term experience of intravitreal brolucizumab in treatment of diabetic macular edema. Russian Annals of Ophthalmology. 2023;139(1):99‑105. (In Russ.)
https://doi.org/10.17116/oftalma202313901199

Подписка 2025 (Russian Annals of Ophthalmology)
 
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PURPOSE

This study examines the efficacy and safety of brolucizumab in the treatment of diabetic macular edema (DME) in real clinical practice in the Russian Federation.

MATERIAL AND METHODS

The study included 14 consecutive treatment-naïve DME patients, among them 7 males and 7 females (21 eyes in total) with mean age of 65.1±8.0 years. Patients underwent standard ophthalmological examination and multimodal imaging, including optical coherence tomography. All patients received intravitreal injections of brolucizumab every 6 weeks. A total of 73 injections were performed. A data analysis was performed for 10 eyes of 10 patients 6 months after initiation of the treatment.

RESULTS

After 4 injections of brolucizumab, best-corrected visual acuity (BCVA) increased statistically significantly from 35.8±13.7 to 41.5±11.9 ETDRS letters (p=0.03), central retinal thickness (CRT) and macular volume (MV) decreased from 411.5±107.4 to 280.2±64.6 microns (p=0.014) and from 7.39±0.92 to 6.16±7.37 mm3 (p=0.0006), respectively. The average gain of visual acuity was 5.7±7.0 letters, average decrease of CRT was –131.3±91.2, and average decrease of MV was –1.21±0.75 mm3. There were no adverse events associated with intraocular inflammation.

CONCLUSION

Intravitreal injections of brolucizumab provide significant anatomical and functional improvement to DME patients in real clinical practice with results comparable to that of randomized clinical trials.

Keywords:

brolucizumab
diabetic macular edema
optical coherence tomography
anti-VEGF

Authors:

Kulikov A.N.

S.M. Kirov Military Medical Academy

Malafeeva A.Yu.

S.M. Kirov Military Medical Academy

Kalinicheva Y.A.

S.M. Kirov Military Medical Academy

Maltsev D.S.

S.M. Kirov Military Medical Academy

Zhalimova V.R.

S.M. Kirov Military Medical Academy

Vasiliev A.S.

S.M. Kirov Military Medical Academy

Received:

07.12.2022

Accepted:

09.02.2023

List of references:

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  2. Diabetic Retinopathy Clinical Research Network, Browning DJ, Glassman AR, Aiello LP, Beck RW, Brown DM, Fong DS, Bressler NM, Danis RP, Kinyoun JL, Nguyen QD, Bhavsar AR, Gottlieb J, Pieramici DJ, Rauser ME, Apte RS, Lim JI, Miskala PH. Relationship between optical coherence tomography-measured central retinal thickness and visual acuity in diabetic macular edema. Ophthalmology. 2007;114(3):525-536.  https://doi.org/10.1016/j.ophtha.2006.06.052
  3. Yuen YS, Tan GSW, Gan NY, Too IHK, Mothe RK, Basa P, Shaikh J. Real-World Evidence in the Management of Diabetic Macular Edema with Intravitreal Anti-VEGFs in Asia: A Systematic Literature Review. Clin Ophthalmol. 2022;16:3503-3526. https://doi.org/10.2147/OPTH.S378392
  4. Kulikov AN, Sosnovskii SV, Berezin RD, Maltsev DS, Oskanov DH, Gribanov NA. Vitreoretinal interface abnormalities in diabetic macular edema and effectiveness of anti-VEGF therapy: an optical coherence tomography study. Clin Ophthalmol. 2017; 11:1995-2002. https://doi.org/10.2147/OPTH.S146019
  5. Das R, Spence G, Hogg RE, Stevenson M, Chakravarthy U. Disorganization of Inner Retina and Outer Retinal Morphology in Diabetic Macular Edema. JAMA Ophthalmol. 2018;136(2):202-208.  https://doi.org/10.1001/jamaophthalmol.2017.6256
  6. Boiko EV, Maltsev DS. Quantitative optical coherence tomography analysis of retinal degenerative changes in diabetic macular edema and neovascular age-related macular degeneration. Retina. 2018;38(7):1324-1330. https://doi.org/10.1097/IAE.0000000000001696
  7. Filippov VM, Petrachkov DV, Budzinskaya MV, Matyushchenko AG. The role of neurodegeneration biomarkers in the management of patients with diabetic retinopathy. Vestnik oftal’mologii. 2021;137(5):314-322. (In Russ.) https://doi.org/10.17116/oftalma2021137052314
  8. Ota M, Nishijima K, Sakamoto A, Murakami T, Takayama K, Horii T, Yoshimura N. Optical Coherence Tomographic Evaluation of Foveal Hard Exudates in Patients with Diabetic Maculopathy Accompanying Macular Detachment. Ophthalmology. 2010;117(10):1996-2002. https://doi.org/10.1016/j.ophtha.2010.06.019
  9. Weiss M, Sim DA, Herold T, Schumann RG, Liegl R, Kern C, Kreutzer T, Schiefelbein J, Rottmann M, Priglinger S, KortUEm KU. Compliance and adherence of patients with diabetic macular edema to intravitreal anti-vascular endothelial growth factor therapy in daily practice. Retina. 2018;38(12): 2293-2300. https://doi.org/10.1097/IAE.0000000000001892
  10. Brown DM, Emanuelli A, Bandello F, Barranco JJE, Figueira J, Souied E, Wolf S, Gupta V, Ngah NF, Liew G, Tuli R, Tadayoni R, Dhoot D, Wang L, Bouillaud E, Wang Y, Kovacic L, Guerard N, Garweg JG. KESTREL and KITE: 52-Week Results From Two Phase III Pivotal Trials of Brolucizumab for Diabetic Macular Edema. Am J Ophthalmol. 2022;238:157-172.  https://doi.org/10.1016/j.ajo.2022.01.004
  11. Kulikov AN, Maltsev DS, Kazak AA, Burnasheva MA. Anterior chamber particles are associated with reduction of intraocular pressure after selective laser trabeculoplasty. Br J Ophthalmol. 2020;104(11):1508-1511. https://doi.org/10.1136/bjophthalmol-2019-315445
  12. Kulikov AN, Maltsev DS, Malafeeva AYu, Perminova SM, Zhalimova VR, Vasiliev AS, Kazak AA. The first experience with brolucizumab for neovascular age-related macular degeneration. Russian Journal of Clinical Ophthalmology. 2022;22(2):108-115.  https://doi.org/10.32364/2311-7729-2022-22-2-108-115
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  14. Tran THC, Verdun S, Le Rouic JF, Uzzan J, Milazzo S, Kodjikian L, Erginay A. Two-Year Outcome of Aflibercept Intravitreal Injection in Vitrectomized Eyes with Diabetic Macular Edema. Clin Ophthalmol. 2022;16: 603-609.  https://doi.org/10.2147/OPTH.S352152
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  16. Kulikov AN, Gazizova IR, Maltsev DS, Malafeeva AYu, Vasiliev AS, Zhalimova VR. Short-term efficacy and safety of Brolucizumab for neovascular age-related macular degeneration in the Russian Federation. Vestnik oftal’mologii. 2022;138(3):55-62. (In Russ.) https://doi.org/10.17116/oftalma202213803155

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