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. 2021 Jul;5(4):326-332.
doi: 10.1177/2474126420975303. Epub 2020 Dec 15.

Brolucizumab-associated intraocular inflammation in eyes without retinal vasculitis

Andre J Witkin  1 , Paul Hahn  2 , Timothy G Murray  3 , J Fernando Arevalo  4 , Kevin J Blinder  5 , Netan Choudhry  6 , Geoff G Emerson  7 , Roger A Goldberg  8 , Stephen J Kim  9 , Joel Pearlman  10 , Eric W Schneider  11 , Homayoun Tabandeh  12 , Robert W Wong  13
Affiliations

Brolucizumab-associated intraocular inflammation in eyes without retinal vasculitis

Andre J Witkin et al. J Vitreoretin Dis. 2021 Jul.

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.

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Conflict of interest statement

Declaration of Conflicting Interests Relevant potential conflicts of interest are reported as follows: AJW: none; PH: Genentech (Consultant, Lecture Fees), Allergan (Consultant); TGM: none; JFA: Springer SBM LLC (Patents/Royalties), DORC International B.V. (Consultant, Lecture Fees), Allergan Inc. (Consultant, Lecture Fees), Bayer (Consultant, Lecture Fees), Mallinckrodt (Consultant), TOPCON (Grant support); KJB: Bausch&Lomb (Consultant, Lecture Fees), Allergan (Consultant, Lecture Fees), Regeneron (Consultant, Lecture Fees), Novartis (Consultant, Lecture Fees), Genentech (Consultant); NC: Allergan (Consultant), Bayer (Consultant), Novartis (Consultant); GGE: Novartis (stock), Regeneron (stock); RAG: Genentech (Research, Speaker, Advisory), Regeneron (Advisory), Novartis (Research, Speaker, Advisory), Allergan (Research, Speaker, Advisory), Aerie (Research), Santen (Research), Graybug (Research), NovoNordisk (Research); SJK: none; JP: none; EWS: none; HT: Alimera (stock); RWW: Novartis (Research)

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