“Real world outcomes of intravitreal brolucizumab for persistent diabetic macular edema”

Abstract Aim Chronic Persistent Diabetic Macular Edema can be a clinical challenge. The aim of this study is to assess the outcomes of intravitreal brolucizumab 6 mg/0.05 ml for persistent diabetic macular edema (P-DME) in a real-world clinical setting. Methods A prospective interventional trial of consecutive patients with P-DME was conducted at a tertiary care center in India. P-DME was defined as edema persisting despite more than three intravitreal anti-VEGF injections or despite a combination of anti-VEGFs, intravitreal steroids and/or laser photocoagulation. The change in visual acuity (VA), central retinal thickness (CRT) and any incidences of adverse effects were analyzed. Results 19 eyes of 13 patients received a mean of 3.3 injections at a mean interval of 11.1 weeks. The median VA improved from 0.40 logMAR (20/50) to 0.35 logMAR (20/44) after a mean period of 13 weeks after the last injection, which was statistically significant ( p = 0.004). The CRT reduced from 517 microns to 237 microns ( p = 0.001). One patient had an episode of intraocular inflammation, which was treated successfully with topical steroids. The same patient again received brolucizumab with no recurrent inflammation. Conclusions Intravitreal brolucizumab helped improve visual acuity in patients with P-DME and achieved a reduction of 54.1% in the CRT at a longer mean reinjection interval. The rate of intraocular inflammation was 5.2% without any permanent visual impairment.