Real-world outcomes, including intraocular inflammation, after intravitreal brolucizumab for diabetic macular edema

This study aimed to assess the real-world outcomes, including intraocular inflammation (IOI), following administration of intravitreal brolucizumab (Beovu 6.0 mg/0.05 mL; Novartis) injections (IVBr) for diabetic macular edema (DME).

Retrospective study.

A total of 56 eyes of 47 patients with DME were treated with IVBr for a minimum follow-up of at least 6 months between May 2022 and November 2023. A "non-strict pro re nata" dosing protocol for IVBr was used. The best corrected visual acuity (BCVA), central macular thickness (CMT), at baseline, 6 months, 1 year, and the latest visit date and IVBr frequency were assessed to evaluate the treatment efficacy. IOI incidence, baseline characteristics of patients with IOI, and treatment course were investigated.

BCVA significantly improved at 6 months and at the latest visit compared to baseline (P = 0.008 and 0.006, respectively). CMT was significantly thinner at 6 months, 1 year, and the latest visit compared to baseline (all, P < 0.001). In 46 eyes followed for more than 1 year, the number of IVBr from baseline to 1 year was 3.8 ± 1.9. Four eyes (7.1%) of four patients (8.5%) developed IOI during the observation period. All patients were women, with an average age of 70.8 ± 9.0 years (59-81 years). Upon IOI diagnosis, all patients received posterior sub-Tenon's triamcinolone acetonide and topical betamethasone sodium phosphate, resulting in rapid resolution.

IOI developed in four of 56 (7.1%) eyes and responded well to prompt steroid therapy after 1.5 years of IVBr use for DME. BCVA and CMT improved at all evaluation time points. With an average of 3.8 IVBr injections per year, IVBr showed long-term efficacy for DME in the real-world setting, although the occurrence of IOI should be monitored.