Real‐world experience with brolucizumab in pro re nata regimen in patients with neovascular age‐related macular degeneration previously treated with ranibizumab and aflibercept and without control of subretinal fluid

Aims/Purpose: to report real‐world outcomes in patients with neovascular age‐related macular degeneration (AMD) previously treated with ranibizumab and/or aflibercept and without control of subretinal fluid (SRF) receiving switch treatment to Brolucizumab in Pro Re Nata (PRN) regimen. Methods: Retrospective study including 11 patients with neovascular AMD previously treated with ranibizumab and/or aflibercept and without control of SRF were included. They received intravitreal treatment with standard 6‐mg intravitreal injections of brolucizumab between April 2022 and March 2023 in PRN regimen. Results: The mean follow‐up after the first injection of brolucizumab was 7.25 months (SD 2.18). The mean number of injections per month (IPM) of ranibizumab and/or aflibercept previous to switch treatment to brolucizumab was 0.81 with standard deviation (SD) of 9.81. The mean number of IPM after starting the treatment with brolucizumab was 0.49 (SD: 0.95). Therefore, the amount of IPM was significatively lower when switching to brolucizumab (p‐value = 0.0003). SRF control was achieved in 9/11 of patients (81.82%). The mean VA increased from was 0.59/1 (SD 0.273) before switch to brolucizumab to 0.64/1 (SD 0.253) (p > 0.05). No cases of intraocular inflammation were described. Conclusions: Brolucizumab in PRN regimen was effective in achieving SRF control in patients with neovascular AMD previously treated with ranibizumab and aflibercept and without control of SRF. Furthermore, the amount of IPM was significatively lower when switching to brolucizumab compared to ranibizumab and/or aflibercept.