Study: Faster regression of persistent residual retinal fluid with brolucizumab in CSC

According to a recent study that compared the efficacy of brolucizumab, half-dose photo dynamic therapy (PDT), and aflibercept in treating chronic central serous chorioretinopathy (CSC), one injection of brolucizumab demonstrated trends of faster regression of persistent residual retinal fluid, greater central choroidal thickness (CCT) and central retinal thickness (CRT) decline, and matched best-corrected visual acuity (BCVA) compared to half-dose PDT in the short term.

A retrospective cohort study reviewed the results of patients with chronic CSC who underwent intravitreal injection of a single injection of brolucizumab or aflibercept in the first 3 months, followed by pro re nata regimens or a single session of half-dose PDT. The primary outcome measure was proportion of eyes that achieved complete absorption of retinal fluid without requiring any rescue treatment; the secondary outcomes included changes in BCVA, CRT, and CCT.

The study included 54 consecutive participants with 18 participants in each group. At months 1 and 2, the brolucizumab group exhibited the highest rate of complete retinal fluid resolution (61% and 77%), followed by the half-dose PDT group (56% and 72%), and lowest in the aflibercept group (28% and 33%), with statistically significant differences noted at month 2. The brolucizumab group demonstrated the most significant reduction in CCT at months 1 and 2 among the 3 groups. Recurrence of retinal fluid in the brolucizumab groups was predominantly observed at month 3, while the half-dose PDT group exhibited the most favorable anatomical results starting from month 3. One participant from the brolucizumab group experienced mild vitritis.

Reference
Huang YT, Tien PT, Chen PY, et al. Comparative efficacy of brolucizumab, half-dose photodynamic therapy, and aflibercept in managing chronic central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol. 2024;doi:10.1007/s00417-024-06373-5