Purpose: To analyze a case series of retinal vasculitis reported to the American Society of Retina Specialists (ASRS) following Food and Drug Administration approval of brolucizumab for treatment of neovascular age-related macular degeneration.
Methods: The ASRS Research and Safety in Therapeutics Committee analyzed clinical and imaging characteristics from submitted reports of retinal vasculitis after brolucizumab.
Results: Retinal vasculitis was reported in 26 eyes of 25 patients (22 [88%] female) after treatment with brolucizumab. Imaging studies were available for 24 of 26 eyes. Most cases (92%) were associated with intraocular inflammation, which presented at a mean of 25 days (range, 3-63 days) after the most recent brolucizumab injection. Mean visual acuity (VA) was 20/52 (range, 20/25-4/200) before the adverse event, 20/151 (range, 20/25-hand motion) at presentation of the adverse event, and 20/243 (range, 20/30-light perception) at last follow-up. Twelve eyes (46%) had a greater than 3-line decrease in VA at final follow-up, and 12 eyes (46%) had a final VA of 20/200 or worse. Analysis of retinal imaging identified vasculopathy that involved retinal arteries (91%), retinal veins (79%), and choroidal vessels (48%). Occlusive disease was apparent on imaging in 83% of eyes. Treatment approaches were varied.
Conclusions: Retinal vasculitis has been identified in a series of eyes following brolucizumab. Although a few eyes in this series were asymptomatic or minimally symptomatic, some eyes had significant vision loss. A careful examination for signs of active inflammation prior to brolucizumab injection is recommended. Once vasculopathy is suspected, angiographic imaging may help define the spectrum of involvement. Optimal treatment strategies remain unknown.
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http://dx.doi.org/10.1177/2474126420930863 | DOI Listing |
Yale J Biol Med
December 2024
Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
: To report a case of cystoid macular edema (CME) secondary to immune recovery uveitis (IRU) in a patient with previous history of cytomegalovirus (CMV) retinitis and leukemia, which was successfully treated with tocilizumab (TCZ), an interleukin-6 (IL-6) receptor antagonist. : The clinical records of the case were reviewed, focusing on demographics, image findings, and clinical course. : A 17-year-old female with a past medical history of T-cell acute lymphoblastic leukemia (T-ALL) undergoing chemotherapy for two years presented with active CMV retinitis.
View Article and Find Full Text PDFJ Ophthalmic Inflamm Infect
December 2024
Inflammatory Eye Disease Clinic, Asociación para Evitar la Ceguera en México, Vicente Garcia Torres No. 46 Coyoacán, Mexico City, 04030, Mexico.
Objective: Describe the proportion of patients with wide-field fluorescein angiographic (WFFA) findings in patients with active anterior scleritis.
Methods: An observational, descriptive, cross-sectional study of the WFFA findings of patients with active anterior scleritis including nodular, diffuse, or necrotizing involvement was performed. Studies were performed with the Heidelberg Spectralis module (102º).
Ophthalmol Ther
December 2024
University Eye Clinic Maastricht, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
Introduction: To investigate 5-year outcomes on intraocular pressure (IOP) and safety of micropulse transscleral cyclophotocoagulation (TSCPC) in patients with glaucoma.
Methods: Patients with mild to advanced glaucoma who underwent a standardized micropulse TSCPC procedure at the University Eye Clinic Maastricht from November 2016 to February 2019 were included.
Results: A total of 165 eyes were included, with outcomes for 112 eyes available after 5-year follow-up.
J Clin Immunol
December 2024
Division of Rheumatology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
TREX1 mutations underlie a variety of human diseases, including retinal vasculopathy with cerebral leukoencephalopathy (RVCL or RVCL-S), a catastrophic adult-onset vasculopathy that is often confused with multiple sclerosis, systemic vasculitis, or systemic lupus erythematosus. Patients with RVCL develop brain, retinal, liver, and kidney disease around age 35-55, leading to premature death in 100% of patients expressing an autosomal dominant C-terminally truncated form of TREX1. We previously demonstrated that RVCL is characterized by high levels of DNA damage, premature cellular senescence, and risk of early-onset breast cancer before age 45.
View Article and Find Full Text PDFEur J Ophthalmol
December 2024
Division of Ocular Immunology, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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