Purpose: To evaluate the usefulness of laser flare meter for the detection and quantitative evaluation of brolucizumab-related intraocular inflammation (IOI).
Subjects and methods: We included 48 eyes of 45 patients with exudative age-related macular degene ra tion (34 eyes of 32 males and 14 eyes of 13 females, mean age 74.5±8.4 years) who visited the Gunma University Hospital from October 2020 to March 2021 and were treated with intravitreal brolucizumab. Forty treatment-naïve eyes of 37 patients were treated with treat-and-extend (TAE) regimen after induction therapy. For 8 eyes of 8 patients who swi tched from intravitreal aflibercept, TAE regimen was applied without induction therapy. If patients had IOI such as iritis, vitritis, and retinal vasculitis during the treatment, they were treated with posterior sub-Tenon triamcinolone injection and betamethasone eye drops. The anterior chamber flare values were measured using a laser flare meter (Kowa FM-600) at each visit.
Results: Brolucizumab-related IOI was observed in 6 eyes. In 42 eyes without IOI, the mean anterior chamber flare value was less than 10 photon counts/msec (pc/ms) at all time points. On the other hand, in 6 eyes with IOI, the mean anterior chamber flare value was 7.3±1.1 pc/ms before onset, 15.3±8.2 pc/ms at onset, and 8.1±2.9 pc/ms 10 weeks later, indicating that the anterior chamber flare values increased at onset and improved after steroid treatment. However, in 2 eyes without iritis, there was no change in flare values before and after the onset of IOI.
Conclusion: Laser flare meter was possible to quantitatively evaluate the anterior chamber inflammation after intravitreal injection of brolucizumab, but it was not possible to predict the onset of brolucizumab-related IOI.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 126: 636-641,2022.