Brolucizumab Related Retinal Vasculitis Treated with Systemic and Local Steroid, and Vitrectomy

Purpose: To describe a case of retinal vasculitis that followed intravitreal brolucizumab injections and its treatment using local and systemic steroid and vitrectomy.Case summary: An 80-year-old male diagnosed with wet age-related macular degeneration presented after experiencing redness, pain, and vision loss in his left eye following a switch in treatment from aflibercept to brolucizumab 2 weeks earlier. Before the switch, the patient’s best corrected visual acuity of the left eye was 0.4; however, on arrival at the clinic, it was finger count at 10 cm. Suspecting intraocular inflammation and retinal vasculitis caused by brolucizumab, he was treated with both local and systemic steroids and later underwent a vitrectomy. Post-surgery, the patient’s symptoms and vision improved and he received additional anti-vascular endothelial growth factor injections. One year after onset, the corrected vision of his left eye was 0.5 with no observed recurrence of intraocular inflammation.Conclusions: When reactions related to intraocular inflammation associated with brolucizumab are identified, aggressive treatment is crucial. The present case report suggests that satisfactory anatomical and visual outcomes can be achieved.