Andre J Witkin1, Paul Hahn2, Timothy G Murray3, J Fernando Arevalo4, Kevin J Blinder5, Netan Choudhry6, Geoff G Emerson7, Roger A Goldberg8, Stephen J Kim9, Joel Pearlman10, Eric W Schneider11, Homayoun Tabandeh12, Robert W Wong13. 1. Tufts Medical Center, Boston, MA. 2. NJ Retina, Teaneck, NJ. 3. Murray Ocular Oncology and Retina, Miami, FL. 4. Wilmer Eye Institute at Johns Hopkins Hospital, Baltimore, MD. 5. The Retina Institute, St. Louis, MO. 6. Vitreous Retina Macula Specialists of Toronto, Toronto, Canada. 7. Retina Center of Minnesota, Minneapolis, MN. 8. Bay Area Retina Associates, Walnut Creek, CA. 9. Vanderbilt University Medical Center, Nashville, TN. 10. Retinal Consultants, Sacramento, CA. 11. Tennessee Retina, Nashville, TN. 12. Retina-Vitreous Associates Medical Group, Los Angeles, CA. 13. Austin Retina Associates, Austin, TX.
Abstract
PURPOSE: To analyze a series of eyes with brolucizumab-associated intraocular inflammation (IOI) without retinal vasculitis reported to the American Society of Retina Specialists (ASRS). METHODS: The ASRS Research and Safety in Therapeutics (ReST) Committee analyzed clinical characteristics from submitted reports of IOI after brolucizumab. Eyes with retinal vasculitis or that received intraocular antibiotics were excluded. RESULTS: Forty-nine eyes of 45 patients were collected. Mean visual acuity (VA) at baseline was 20/49 (range 20/20 - 5/200). Patients presented with IOI a mean of 24 (range 3-63) days after most recent brolucizumab injection; 61% presented for an unscheduled visit while 39% presented at routine follow-up. Mean VA at IOI presentation was 20/67 (range 20/20 - 3/200). Most common symptoms were floaters (78%) and blurry vision (76%). Pain (20%) and redness (16%) were less common; 3 (6%) eyes were asymptomatic. IOI was anterior only in 18%, posterior only in 31%, and both anterior and posterior in 51% of eyes. Treatment included topical steroids alone in 67% eyes, while 10% eyes received no treatment. Mean VA at last follow-up was 20/56 (range 20/20 - 1/200). Three (6%) eyes lost 3 or more lines and 1 (2%) eye lost 6 or more lines. CONCLUSIONS: Brolucizumab-associated IOI without retinal vasculitis typically presented with a delayed onset of a few weeks. Often, visual acuity decline was relatively mild. Most symptoms resolved and nearly all had a return to baseline VA, but a small percentage of patients had a significant decrease in VA at last follow-up.
PURPOSE: To analyze a series of eyes with brolucizumab-associated intraocular inflammation (IOI) without retinal vasculitis reported to the American Society of Retina Specialists (ASRS). METHODS: The ASRS Research and Safety in Therapeutics (ReST) Committee analyzed clinical characteristics from submitted reports of IOI after brolucizumab. Eyes with retinal vasculitis or that received intraocular antibiotics were excluded. RESULTS: Forty-nine eyes of 45 patients were collected. Mean visual acuity (VA) at baseline was 20/49 (range 20/20 - 5/200). Patients presented with IOI a mean of 24 (range 3-63) days after most recent brolucizumab injection; 61% presented for an unscheduled visit while 39% presented at routine follow-up. Mean VA at IOI presentation was 20/67 (range 20/20 - 3/200). Most common symptoms were floaters (78%) and blurry vision (76%). Pain (20%) and redness (16%) were less common; 3 (6%) eyes were asymptomatic. IOI was anterior only in 18%, posterior only in 31%, and both anterior and posterior in 51% of eyes. Treatment included topical steroids alone in 67% eyes, while 10% eyes received no treatment. Mean VA at last follow-up was 20/56 (range 20/20 - 1/200). Three (6%) eyes lost 3 or more lines and 1 (2%) eye lost 6 or more lines. CONCLUSIONS: Brolucizumab-associated IOI without retinal vasculitis typically presented with a delayed onset of a few weeks. Often, visual acuity decline was relatively mild. Most symptoms resolved and nearly all had a return to baseline VA, but a small percentage of patients had a significant decrease in VA at last follow-up.
Authors: Jonathan P Greenberg; Peter Belin; John Butler; Daniel Feiler; Christian Mueller; Andrew Tye; Steven M Friedlander; Geoffrey G Emerson; Philip J Ferrone Journal: Ophthalmol Retina Date: 2019-04-11
Authors: Pravin U Dugel; Adrian Koh; Yuichiro Ogura; Glenn J Jaffe; Ursula Schmidt-Erfurth; David M Brown; Andre V Gomes; James Warburton; Andreas Weichselberger; Frank G Holz Journal: Ophthalmology Date: 2019-04-12 Impact factor: 12.079
Authors: Paul Hahn; Mina M Chung; Harry W Flynn; Suber S Huang; Judy E Kim; Tamer H Mahmoud; SriniVas R Sadda; Pravin U Dugel Journal: JAMA Ophthalmol Date: 2015-04 Impact factor: 7.389
Authors: Andre J Witkin; Paul Hahn; Timothy G Murray; J Fernando Arevalo; Kevin J Blinder; Netan Choudhry; Geoff G Emerson; Roger A Goldberg; Stephen J Kim; Joel Pearlman; Eric W Schneider; Homayoun Tabandeh; Robert W Wong Journal: J Vitreoretin Dis Date: 2020-07-01