Prechoroidal Cleft Regression After Switch to Intravitreal Brolucizumab

Area of Science:

• Ophthalmology
• Retinal Diseases
• Macular Degeneration

Background:

• Prechoroidal clefts are a negative prognostic biomarker in neovascular age-related macular degeneration (nAMD).
• These clefts appear as a hyporeflective space between Bruch's membrane and fibrovascular pigment epithelium detachment (PED).
• Previous treatments with anti-VEGF agents have shown variable success in cleft regression.

Observation:

• This case report details a patient with an unresponsive prechoroidal cleft.
• The patient received intravitreal brolucizumab after failing other treatments.
• The cleft showed complete anatomical regression following brolucizumab administration.

Findings:

• Intravitreal brolucizumab achieved complete anatomical regression of a prechoroidal cleft.
• The regression was sustained during the follow-up period.
• No adverse events, such as RPE tears or intraocular inflammation, were observed.

Implications:

• Brolucizumab demonstrates potential efficacy in treating prechoroidal clefts in nAMD.
• This represents the first report on brolucizumab's effect on prechoroidal clefts.
• Further research is needed to understand the clinical implications and pathogenesis of prechoroidal clefts.