PurposeTo assess the longitudinal changes of neovascularisations (NV) in a patient with proliferative diabetic retinopathy (PDR) after panretinal photocoagulation under additive intravitreal treatment with Vascular Endothelial Growth Factor (VEGF)‐inhibitors using optical coherence tomography angiography (OCTA).MethodsWe present two patients after several sessions of panretinal photocoagulation and intravitreal treatment with VEGF‐Inhibitors due to DME and also to treat PDR. Multimodal imaging including fundus photography and optical coherence tomography angiography (OCTA) was used to monitor the effect of VEGF‐inhibitors on the NV. We measured the size of the NV at baseline and at 1, 3, and 6 months and also compared morphology of the NV.ResultsAll neovascularisations of the disc and elsewhere showed a significant regression in morphology and also in their area. No adverse events were reported.ConclusionsSuccessful treatment of PDR with VEGF‐Inhibitors with a significant regression of the NV could be shown by OCTA. In the future, treatment response should be closely monitored by using multimodal imaging including OCTA to guarantee the best therapy for our patients. Precise quantification of the neovascularization’s area by OCTA makes it a useful tool for monitoring the response of retinal neovascular lesions to anti‐VEGF treatment.
PurposeTo describe the management of intraocular inflammation after treatment with vascular endothelial growth factor (VEGF)–inhibitor brolucizumab in two patients.MethodsWe present the treatment course of two patients who received an upload with brolucizumab in one eye due to age‐related macular degeneration (AMD) after previous intravitreal therapy with other VEGF‐inhibitors had not been effective anymore. Both patients developed a delayed intraocular inflammation (IOI) with emphasis on the vitreous.ResultsFurther intravitreal therapy with brolucizumab was stopped in both patients, other causes than sterile uveitis were excluded and local therapy with steroidal eye drops was initiated. Patient B additionally received body weight‐adapted therapy with oral steroids due to severe inflammation in the vitreous space. Initially and during the whole course, there was no evidence of vasculitis. Both patients reached their initial visual acuity within 4 weeks.ConclusionsSuccessful treatment of IOI after treatment with brolucizumab requires thorough and frequent examinations to identify IOI early. With an immediate cessation of therapy with brolucizumab and additional therapy with either local steroids or a combination of local and systemic steroids both patients fully recovered from medication‐associated uveitis without any remnants.
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