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

PURPOSE: 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).

METHODS: 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.

RESULTS: 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).

CONCLUSION: 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.