Brolucizumab-induced retinal vasculitis – An Indian perspective

Brar, Manpreet; Dogra, Mohit; Grewal, SP S; Sharma, Mukut; Grewal, Dilraj S.

doi:10.4103/ijo.ijo_295_22

Indian J Ophthalmol Case Rep

2022

DOI: 10.4103/ijo.ijo_295_22

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Brolucizumab-induced retinal vasculitis – An Indian perspective

Manpreet Brar¹,

Mohit Dogra²,

SP S Grewal³

et al.

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Cited by 2 publications

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“…Brolucizumab was introduced in India for the treatment of nAMD with regulatory approvals in October 2020. Though retina specialists in India have not seen devasting IOI due to brolucizumab, anecdotal cases have emerged,[ 17 , 18 ] prompting the vitreoretinal society of India to release a cautionary note. Yet, the incidence of IOI in Indian eyes following the use of brolucizumab for nAMD is largely unknown.…”

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confidence: 99%

Incidence, clinical features, risk factors, and outcomes of Intraocular inflammation following Brolucizumab in Indian eyes – A multicentric study

Chakraborty

Mondal

Sengupta

et al. 2023

Indian Journal of Ophthalmology

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Purpose: To report the incidence, clinical features, potential risk factors, and outcomes of intraocular inflammation (IOI) following brolucizumab in Indian eyes. Methods: All consecutive patients diagnosed with brolucizumab-induced IOI from 10 centers in eastern India between October 2020 and April 2022 were included. Results: Of 758 injections given during the study period across centers, 13 IOI events (1.7%) were recorded attributable to brolucizumab. The IOI occurred after the first dose in two eyes (15%) (median 45 days after brolucizumab), second dose in six eyes (46%) (median = 8.5 days), and third dose (39%) in the remaining five eyes (median 7 days). Reinjections of brolucizumab were administered at a median interval of 6 weeks (interquartile range = 4–10 weeks) in the 11 eyes, where IOI occurred after the second or third dose. Eyes that experienced IOI after the third dose had received a significantly greater number of previous antivascular endothelial growth factor injections (median = 8) compared to those who developed it after the first or second dose (median = 4) ( P = 0.001). Anterior chamber cells were seen in almost all eyes ( n = 11, 85%), while peripheral retinal hemorrhages were seen in two eyes, and one eye showed branch artery occlusion. Two-thirds of patients ( n = 8, 62%) recovered with a combination of topical and oral steroids, while remaining recovered with topical steroids alone. Irreversible visual loss was not seen in any eye, and median vision recovered to pre-IOI levels by 3 months’ time point. Conclusion: Brolucizumab-induced IOI was relatively rare, occurring in 1.7% of eyes, was more common after the second or third injection, especially in those who required frequent reinjections every 6 weeks, and occurred earlier with increasing number of previous brolucizumab injections. Continued surveillance is necessary even after repeated doses of brolucizumab.

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mentioning

confidence: 99%

Incidence, clinical features, risk factors, and outcomes of Intraocular inflammation following Brolucizumab in Indian eyes – A multicentric study

Chakraborty

Mondal

Sengupta

et al. 2023

Indian Journal of Ophthalmology

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Delayed noninfectious intraocular inflammation and retinal vasculitis after single intravitreal Brolucizumab® injection for polypoidal choroidal vasculopathy

Venkatesh,

Mishra,

Mangla

et al. 2024

Indian Journal of Ophthalmology - Case Reports

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A 52-year-old woman with extrafoveal polypoidal choroidal vasculopathy (PCV) in her right eye was treated with a single intravitreal injection of 6 mg/0.05 ml brolucizumab (BZB) and focal thermal laser therapy. The patient complained of redness and blurred vision in her right eye for the previous week at the 4-week follow-up visit. PCV-related clinical findings revealed complete regression. There was circumcorneal congestion, diffuse nongranulomatous keratic precipitates, grade 2+ anterior chamber flare and cells, grade 1+ vitreous haze, posterior vitreous cells, hyperemic disc with perivascular sheathing, and retinal vasculitis. Following treatment with topical and systemic steroids, the intraocular inflammation (IOI) worsened, and vision was reduced to 6/60 after a week of steroid therapy at a subsequent follow-up visit. A pars plana vitrectomy was performed, and vitreous cytology revealed small lymphocytes with no evidence of intraocular infection. At the 6-month follow-up visit, the patient’s vision had improved to 6/6 and the signs of IOI had resolved. This case demonstrates that even after a single intravitreal injection of BZB, an eye that had previously received no antivascular endothelial growth factor injection can develop IOI.

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Brolucizumab-induced retinal vasculitis – An Indian perspective

Cited by 2 publications

References 4 publications

Incidence, clinical features, risk factors, and outcomes of Intraocular inflammation following Brolucizumab in Indian eyes – A multicentric study

Incidence, clinical features, risk factors, and outcomes of Intraocular inflammation following Brolucizumab in Indian eyes – A multicentric study

Delayed noninfectious intraocular inflammation and retinal vasculitis after single intravitreal Brolucizumab® injection for polypoidal choroidal vasculopathy

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