ABSTRACT
Background: Neovascular age-related macular degeneration (nAMD), also known as wet AMD, is a chronic eye disease that affects the macula, which is the central part of the retina responsible for sharp, central vision. Brolucizumab is a type of anti-vascular endothelial growth factor (VEGF) drug, which works by blocking the activity of a protein called VEGF that promotes the growth of abnormal blood vessels under the macula in neovascular AMD. The aim of this study was to evaluate the clinical outcome of brolucizumab in the treatment of neovascular age-related macular degeneration. Material & Methods: This prospective observational study was conducted in Department of Ophthalmology, Bangladesh Eye Hospital & Institute Ltd, Dhaka, Bangladesh, during the period from February 2022 to February 2023. Total 60 patients with neovascular AMD were included in this study who were treated with brolucizumab. Results: The mean age of the patients was 74.3 (SD±9.8) years. Majority of the study subjects were (51.7%) female patients in the study. In our study, majority (38.3%) of the patients had only their right eye affected. In optical coherence tomography (OCT) findings, we found that a high percentage of patients had subretinal fluid (85%), intraretinal fluid (61.7%), and sub-RPE fluid (83.3%). The BCVA showed a significant change after 12 weeks of treatment, as indicated by the P-value of 0.0007. Here improvement of vision was seen in patients with AMD with active Choroidal neovascularization (CNV). But in case of AMD with macular scar, no improvement of vision was seen. In addition, the SRT, FCP, and CMT parameters also showed a statistically significant (P<0.001) improvement after brolucizumab treatment. In our study, 4 patients (6.7%) experienced intraocular inflammation, which is inflammation within the eye, 2 patients (3.3%) reported cloudy vision, and 3 patients (5%) experienced eye redness as a complication of the treatment. The majority of the patients, 51 (85%) did not experience any complications from the treatment. After treatment, improved vision was seen in most of the study patients (70%) and 30% had no improvement. Conclusion: From the findings of our study, it can be concluded that brolucizumab may be an effective treatment for neovascular AMD, as it can improve the best-corrected visual acuity and structural outcomes of the retina such as subfoveal retinal thickness, foveal center point, and central macular thickness. There was also a tolerable complication rate after treatment.
ABSTRACT
Background: Chronic Kidney Disease (CKD) is a growing public health problem affecting millions of people worldwide. Along with its well-known systemic effects, CKD has been associated with various ocular abnormalities, including uveitis, macular edema, and retinal vascular changes. Early detection and management of these ocular complications can prevent significant visual loss and improve the quality of life of patients with CKD. This highlights the importance of regular ophthalmic examinations as part of the comprehensive management of CKD. The aim of this study was to evaluate the ocular status of chronic kidney disease. Material & Methods: This was an observational study. The present study was conducted on 150 Patients attending the Department of Ophthalmology at Dr. Sirajul Islam Medical College and Hospital Ltd, Dhaka, Bangladesh. The duration of the study was 2 years. All collected data was entered in MS Excel and Statistical analysis was done using the SPSS-24 version. Results: The study analyzed a population between the ages of 40-59 years, with a slight majority of women (52.67%) and moderate CKD (64.00%). The most common cause of CKD in the population was hypertension and diabetes (52.00%). 66.67% of 300 eyes had good vision (6/18 or better), while the remainder had impaired or legally blind vision (increasing as the severity of CKD increases). Ocular anterior segment findings showed that lid oedema and conjunctival pallor were present in 3.5% and 56.9% of the eyes, respectively. Dry eyes and cataract were present in 5.6% and 11.1% of the eyes, respectively. Hypertensive retinopathy was present in 48.00% of eyes in the moderate CKD group, and diabetic retinopathy was present in 32.00% of eyes in the severe and end-stage CKD groups. Maculopathy and vitreous hemorrhage were present in 12.67% and 6.33% of eyes in the end-stage CKD group. Of the 100 eyes with poor or blind visual acuity, 24 (24%) were affected by Maculopathy and 21 (21%) by Cystoid Macular Edema. The causes of visual impairment were also listed with their corresponding percentage. Conclusion: In CRF patients, eye exams can detect ocular problems. Early treatment prevents negative outcomes and those with a history of abnormal renal function need close monitoring due to increased risk of vision loss. Awareness of ocular complications is important, as well as thorough eye exams and control of diabetes and hypertension for maintaining eye health.