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Retinal vasculitis after intravitreal injection of brolucizumab

  • Fares Antaki
    Affiliations
    Department of Ophthalmology, Université de Montréal, Montreal, Que.

    Centre Universitaire d'Ophtalmologie (CUO), Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l’Île-de-Montréal, Montreal, Que.
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  • Julie Vadboncoeur
    Correspondence
    Correspondence to Julie Vadboncoeur, MD, Centre Universitaire d'Ophtalmologie (CUO), Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l’Île-de-Montréal, Montreal QC
    Affiliations
    Department of Ophthalmology, Université de Montréal, Montreal, Que.

    Centre Universitaire d'Ophtalmologie (CUO), Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l’Île-de-Montréal, Montreal, Que.
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      An 82-year-old man with age-related macular degeneration presented with painful vision loss in the right eye 42 days after his third brolucizumab injection (Beovu, Novartis, Basel, Switzerland). Visual acuity was light perception (baseline, 20/150). Examination revealed moderate to severe vitritis, arterial sheathing, diffuse arterial and venous narrowing, and perivenular hemorrhages (Fig. 1A,1B). Fluorescein angiography demonstrated extensive arterial and venous filling defects with peripheral nonperfusion (Fig. 1C, 1D). Occlusive retinal vasculitis associated with brolucizumab injection can lead to irreversible vision loss. Before injecting, a meticulous examination for signs of inflammation is crucial, and patients must be informed about this potential complication.
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