COMPARISON OF OCULAR BLOOD FLOW CHANGES AT 30 MINUTES AFTER INTRAVITREAL INJECTION OF FARICIMAB, BROLUCIZUMAB, AND AFLIBERCEPT 2 mg FOR NEOVASCULAR AGE-RELATED MACULAR.

Abstract

To investigate ocular blood flow before and 30 minutes postinjection of antivascular endothelial growth factor agents in eyes with neovascular age-related macular degeneration and to compare the reduction rates of ocular blood flow among three groups: intravitreal faricimab injections (faricimab-treated), intravitreal brolucizumab injections (brolucizumab-treated), and intravitreal aflibercept 2 mg injections (aflibercept-treated). This retrospective observational case series included 45 eyes of 45 Japanese patients with neovascular age-related macular degeneration treated with faricimab, brolucizumab, or aflibercept 2 mg. Ocular blood flow at the optic nerve head (ONH MV) and the choroid (choroid mean blur rate) was analyzed before and 30 minutes after injections using laser speckle flowgraphy. The mean optic nerve head MV and choroid mean blur rate decreased significantly 30 minutes postinjection by 12.0% ± 15.3% and 9.7% ± 8.8% in the faricimab-treated group, 9.5% ± 7.9% and 18.2% ± 12.9% in the brolucizumab-treated group, and 10.4% ± 11.9% and 6.0% ± 7.7% in the aflibercept-treated group. There were no significant differences in the reduction rates of optic nerve head MV among the three groups. However, the brolucizumab-treated group showed a greater reduction in choroid mean blur rate than the aflibercept-treated group (faricimab vs. brolucizumab: P = 0.161; faricimab vs. aflibercept: P = 0.631; brolucizumab vs. aflibercept: P = 0.027). Ocular blood flow significantly decreased 30 minutes postinjection in faricimab-treated, brolucizumab-treated, or aflibercept-treated eyes with neovascular age-related macular degeneration. Brolucizumab-treated eyes showed a significantly greater reduction in choroidal blood flow than aflibercept-treated eyes.