CSTTA may prevent brolucizumab related intraocular inflammation in nAMD

A study was conducted to investigate the efficacy of sub-Tenon's capsule triamcinolone acetonide (STTA) injections for preventing the development of intraocular inflammation (IOI) related to intravitreal injection (IVI) of brolucizumab for neovascular age-related macular degeneration (nAMD).

Consecutive patients with nAMD treated with brolucizumab IVIs were studied retrospectively. All eyes treated with brolucizumab in the clinic were switched from another anti-vascular endothelial growth factor agent. After the fourth case of IOI related to brolucizumab IVI, all eyes treated with brolucizumab received an STTA injection. The patients were divided into two groups: brolucizumab alone and brolucizumab combined with an STTA injection.

Results:

• Forty-four eyes (44 patients) treated with at least one brolucizumab IVI have studied: 14 eyes received brolucizumab IVI alone and 30 eyes received the combination therapy.
• IOI related to brolucizumab IVIs developed in four (28.6%) of 14 eyes in the brolucizumab group; IOI was severe in one eye, moderate in two eyes, and mild in one eye according to the HAWK and HARRIER trial definition; IOI did not develop in the 30 eyes that received combination therapy, the difference of which reached significance (p = 0.012).
• Regarding combination therapy, the intraocular pressure in three (10%) eyes increased to 22 to about 26 mmHg after the STTA injection and returned to the normal range within 2 months without medication; no cataracts developed during this short mean follow-up period of 7.1 ± 0.4 months.

Thus, the results indicated the possible preventative effect of an STTA injection on the development of brolucizumab-associated IOI.

Reference:

Hikichi, T. Sub-Tenon's capsule triamcinolone acetonide injection to prevent brolucizumab-associated intraocular inflammation. Graefes Arch Clin Exp Ophthalmol 260, 2529–2535 (2022). https://doi.org/10.1007/s00417-022-05611-y

Keywords:

Concomitant use, STTA, brolucizumab, prevent, intraocular, inflammation, Graefe's Archive for Clinical and Experimental Ophthalmology, Hikichi, T., triamcinolone acetonide, Sub-Tenon's capsule triamcinolone acetonide injection, Anti-vascular endothelial growth factor therapy, Intraocular inflammation, Neovascular age-related macular degeneration