Exudative retinal detachment following intravitreal brolucizumab injection.

Abstract

To report an unusual case of a patient who presented with intraocular inflammation and an exudative retinal detachment following first brolucizumab injection, and to compare this case to the existing literature. The patient's chart was thoroughly reviewed, and notes were made on visual acuities and ocular examination findings at each relevant visit. Optical coherence tomography (OCT) and ultra-wide fluorescein angiography (UWFA) images were taken across multiple timepoints. An 80-year-old female being treated for neovascular age-related macular degeneration (nAMD) presented 11 days after her first intravitreal injection of brolucizumab with intraocular inflammation and an exudative retinal detachment. She was treated with systemic steroids. The patient's intraocular inflammation and exudative retinal detachment resolved three weeks after brolucizumab injection. In the literature, the incidence of intraocular inflammation (IOI) has been reported to be higher with brolucizumab versus aflibercept, but most of these cases were considered to be mild to moderate in severity. More recently, reports of severe IOI and retinal vasculitis associated with brolucizumab have been published in post-marketing surveillance articles. To our knowledge, this is the first report of exudative retinal detachment after intravitreal brolucizumab injection. As our experience with this new drug continues to grow, reports of these events are critical to increase our understanding, so that future management strategies can be developed to improve patient outcomes.