Brolucizumab is the most recently approved anti-vascular endothelial growth factor (anti-VEGF) agent for neovascular age-related macular degeneration (nAMD). Abicipar pegol is another agent that has been filed for marketing approval with the United States Food and Drug Administration and the European Medicines Agency [1, 2]. The common aspect of these molecules is the low molecular weight, a different structure compared to the previous anti-VEGF molecules, and the occurrence of an emerging phenomenon of retinal vasculitis in the phase 3 trials. [3, 4].

The arrival of brolucizumab was highly anticipated by the ophthalmological community due to its better fluid control despite its less frequent recommended dosing schedule in eyes with nAMD. It also provided a new option for eyes that were non-responsive to the previously available anti-VEGF options such as ranibizumab (Lucentis, Novartis) and aflibercept (Eylea, Bayer). Seventy thousand doses of the molecule have been administered till April 1, 2020. [5]. The brolucizumab early real-world study (BREW), an early real-world visual outcome report has been recently published by our group [6]. Forty-two eyes of 42 patients, previously treated with other anti-VEGFs that underwent 60 injections of brolucizumab showed significant improvement in the mean central sub-foveal thickness, while maintaining the best-corrected visual acuity. Our study did not find any safety flag during the follow-up period.

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