J Korean Ophthalmol Soc.  2024 Feb;65(2):161-166. 10.3341/jkos.2024.65.2.161.

Retinal Occlusive Vasculitis after Intravitreal Injection of Brolucizumab

• Lee JH
• Moon TK
• Ji YS

• KMID: 2552436
• DOI: http://doi.org/10.3341/jkos.2024.65.2.161

Abstract

Purpose
To report two instances of retinal arterial occlusive vasculitis following intravitreal injection of brolucizumab.
Case summary
Two patients noted decreased visual acuity approximately one month after receiving intravitreal brolucizumab injections to treat wet age-related macular degeneration. In case 1, an 85-year-old male reported a reduction in visual acuity in his left eye, declining from a Snellen measurement of 0.2 to hand motion. In case 2, a 70-year-old female experienced a decline in visual acuity in her right eye from 0.4 to finger count at 50 cm. Both patients presented with anterior chamber reactions, and fluorescein angiography demonstrated delayed retinal artery filling time, leading to the diagnosis of retinal occlusive vasculitis. They were treated with both topical and systemic corticosteroids. For case 1, a subsequent vitrectomy was performed to remove the inflammatory membrane located behind the intraocular lens. However, despite aggressive interventions, neither patient showed visual improvement.
Conclusions
Retinal occlusive vasculitis, which can result from intraocular inflammation, may occur after intravitreal brolucizumab injection. This condition can lead to significant visual impairment even with aggressive treatment.

Keyword

Brolucizumab, Intraocular inflammation, Retinal vasculitis