Successful treatment of intraocular inflammation following intravitreal brolucizumab

Abstract

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.