Abstract
Age-related macular degeneration and its complication, subretinal neovascularization, are common causes of progressive, irreversible impairment of central vision. Anti-vascular endothelial growth factor (anti-VEGF) therapy has improved the visual outcome and provided an evolution in the treatment of retinal disease. The current four anti-VEGF drugs – pegaptanib, ranibizumab, aflibercept, and bevacizumab – have been administered for many years. A new anti-VEGF agent, brolucizumab, was approved by the U.S. Food and Drug Administration (FDA) in late 2019 for the treatment of wet age-related macular degeneration. Brolucizumab is a novel single-chain fragment variable antibody that inhibits all isoforms of VEGF-A and has been suggested to have more tissue penetration. Despite all the benefits, there are some reports of serious side effects that need to be understood in managing patients. Brolucizumab has been reported to cause occlusive retinal vasculitis in the setting of intraocular inflammation, which has not been seen in other anti-VEGF medications. A PubMed and Scopus search was performed and all article types were included. In the present article, we have reviewed the reported side effects of brolucizumab.
Highlights
Eleven and twenty-one cases of occlusive vasculitis were reported in February 23rd and March 30th of 2020, respectively, by The American Society of Retina Specialists (ASRS).[15]
Intravitreal dexamethasone was implanted in left eye which resulted in improvement of the inflammation. They hypothesized that type IV hypersensitivity reaction is responsible for intraocular inflammation (IOI)
Baumal and colleagues[18] evaluated 15 eyes of 12 patients with retinal vasculitis and IOI due to intravitreal injection of brolucizumab from 10 centers in United States to identify features and outcomes of this condition. They reported that retinal vasculitis and IOI is JOURNAL OF OPHTHALMIC AND VISION RESEARCH VOLUME 16, ISSUE 4, OCTOBER-DECEMBER 2021
Summary
Age-related macular degeneration (AMD) is the leading cause of blindness in the developed. Side Effects of Brolucizumab; Motevasseli et al newer anti-vascular endothelial growth factors (anti-VEGF) such as bevacizumab (Avastin; Genentech, South San Francisco, California), ranibizumab (Lucentis; Genentech, South San Francisco, California), and aflibercept (Eylea; Regeneron, Tarrytown, New York).[2,3,4] despite significant advancements, long-term results are less promising, since about 30% of involved eyes will experience significant vision loss due to geographic atrophy in the course of the treatment.[5, 6] Considering the burden of repeated injections and consequent lower patient’s compliance, the need for newer and more efficient treatments is clear.[7]
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