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.