Comparison of the regressive effects of aflibercept and brolucizumab on pigment epithelial detachment

Background To compare the regressive effects of aflibercept and brolucizumab on pigment epithelial detachment (PED) in age-related macular degeneration. Methods Eighty-three eyes of 83 patients diagnosed with type 1 macular neovascularization were included and retrospectively analysed using multimodal imaging. Forty-nine eyes were treated with intravitreal aflibercept injections (IVA group), and 34 eyes were treated with brolucizumab (IVBr group), with three consecutive injections administered as induction therapy. Before treatment and 1, 2, and 3 months after the first treatment, the maximum height (MH) and maximum diameter (MD) of the PED were measured using optical coherence tomography in each treatment group. Results In the IVA group, MH at baseline (228 ± 169 μm) diminished to 180 ± 150 ( P = 0.2558), 165 ± 140 ( P = 0.0962), and 150 ± 129 µm ( P = 0.0284) at 1, 2, and 3 months after treatment, respectively; the reduction at 3 months was significant. In contrast, in the IVBr group, the MH was 307 ± 254 µm before treatment, and it decreased to 183 ± 156 µm ( P = 0.0113), 139 ± 114 µm ( P = 0.0003), and 125 ± 126 µm ( P < 0.0001) at 1, 2, and 3 months after treatment, respectively, and the reduction at 1 month was significant. In both groups, the MD did not regress significantly. Conclusions The results suggested that the MH of PED after IVBr treatment regressed faster than that after IVA treatment.