Intraocular Inflammation Secondary to Intravitreal Brolucizumab Injection for Neovascular Age-Related Macular Degeneration in a Patient with Cognitive Impairment
<i>Background and Objectives</i>: Brolucizumab (IVBr) is a recently introduced anti-vascular endothelial growth factor (anti-VEGF) which has been found to be very effective in treating neovascular age-related macular degeneration (nAMD). We reported our findings in a case of nAMD that de...
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MDPI AG
2023-10-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/10/1856 |
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| author | Natsuki Ueji Yoko Mase Akiko Kubo Hisashi Matsubara Shinichiro Chujo Yoshitsugu Matsui Mineo Kondo |
| author_facet | Natsuki Ueji Yoko Mase Akiko Kubo Hisashi Matsubara Shinichiro Chujo Yoshitsugu Matsui Mineo Kondo |
| author_sort | Natsuki Ueji |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Brolucizumab (IVBr) is a recently introduced anti-vascular endothelial growth factor (anti-VEGF) which has been found to be very effective in treating neovascular age-related macular degeneration (nAMD). We reported our findings in a case of nAMD that developed intraocular inflammation (IOI) after IVBr injections. <i>Materials and Methods</i>: A 79-year-old man was referred to our hospital complaining of reduced vision in both eyes of one-month’s duration. His decimal best-corrected visual acuity (BCVA) was 0.9 in the right eye and 1.0 in the left eye. He was diagnosed with nAMD in the left eye and was treated with intravitreal aflibercept (IVA). Despite the three-monthly IVA injections, the serous retinal pigment epithelial detachment (PED) and subretinal fluid (SRF) remained, and the VA gradually decreased to 0.1. Because of the patient being refractory to aflibercept treatment, we switched to 3-monthly IVBr injections. The BCVA gradually improved to 0.3 and optical coherence tomography (OCT) showed an absence of the serous PED and SRF. Three weeks after his third IVBr, he returned to our hospital with a complaint of reduced vision in his left eye that he first noted two weeks earlier. Our examination of the left eye showed signs of IOI mainly in the anterior chamber. The inflammation improved with topical steroids but the treatment of the IOI was delayed for two weeks. The patient was instructed that it was important to begin the treatment as soon as the symptoms of IOI developed. We then performed the Mini-Mental State Examination (MMSE), and his score indicated that he had cognitive impairment. <i>Conclusions</i>: We concluded that before beginning IVBr treatment in nAMD patients, a careful assessment must be made of the cognitive status of the patient. |
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| spelling | doaj.art-f3dfa6c1f84145969a0a4e507d8df9262023-11-19T17:18:17ZengMDPI AGMedicina1010-660X1648-91442023-10-015910185610.3390/medicina59101856Intraocular Inflammation Secondary to Intravitreal Brolucizumab Injection for Neovascular Age-Related Macular Degeneration in a Patient with Cognitive ImpairmentNatsuki Ueji0Yoko Mase1Akiko Kubo2Hisashi Matsubara3Shinichiro Chujo4Yoshitsugu Matsui5Mineo Kondo6Ophthalmology, Kinan Hospital, 4750 Atawa, Mihama-cho, Minaminuro-gun 519-5293, JapanOphthalmology, Kinan Hospital, 4750 Atawa, Mihama-cho, Minaminuro-gun 519-5293, JapanOphthalmology, Kinan Hospital, 4750 Atawa, Mihama-cho, Minaminuro-gun 519-5293, JapanDepartment of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi 514-8507, JapanDepartment of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi 514-8507, JapanDepartment of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi 514-8507, JapanDepartment of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi 514-8507, Japan<i>Background and Objectives</i>: Brolucizumab (IVBr) is a recently introduced anti-vascular endothelial growth factor (anti-VEGF) which has been found to be very effective in treating neovascular age-related macular degeneration (nAMD). We reported our findings in a case of nAMD that developed intraocular inflammation (IOI) after IVBr injections. <i>Materials and Methods</i>: A 79-year-old man was referred to our hospital complaining of reduced vision in both eyes of one-month’s duration. His decimal best-corrected visual acuity (BCVA) was 0.9 in the right eye and 1.0 in the left eye. He was diagnosed with nAMD in the left eye and was treated with intravitreal aflibercept (IVA). Despite the three-monthly IVA injections, the serous retinal pigment epithelial detachment (PED) and subretinal fluid (SRF) remained, and the VA gradually decreased to 0.1. Because of the patient being refractory to aflibercept treatment, we switched to 3-monthly IVBr injections. The BCVA gradually improved to 0.3 and optical coherence tomography (OCT) showed an absence of the serous PED and SRF. Three weeks after his third IVBr, he returned to our hospital with a complaint of reduced vision in his left eye that he first noted two weeks earlier. Our examination of the left eye showed signs of IOI mainly in the anterior chamber. The inflammation improved with topical steroids but the treatment of the IOI was delayed for two weeks. The patient was instructed that it was important to begin the treatment as soon as the symptoms of IOI developed. We then performed the Mini-Mental State Examination (MMSE), and his score indicated that he had cognitive impairment. <i>Conclusions</i>: We concluded that before beginning IVBr treatment in nAMD patients, a careful assessment must be made of the cognitive status of the patient.https://www.mdpi.com/1648-9144/59/10/1856age-related macular degenerationAMDintraocular inflammationIOIbrolucizumabdementia |
| spellingShingle | Natsuki Ueji Yoko Mase Akiko Kubo Hisashi Matsubara Shinichiro Chujo Yoshitsugu Matsui Mineo Kondo Intraocular Inflammation Secondary to Intravitreal Brolucizumab Injection for Neovascular Age-Related Macular Degeneration in a Patient with Cognitive Impairment Medicina age-related macular degeneration AMD intraocular inflammation IOI brolucizumab dementia |
| title | Intraocular Inflammation Secondary to Intravitreal Brolucizumab Injection for Neovascular Age-Related Macular Degeneration in a Patient with Cognitive Impairment |
| title_full | Intraocular Inflammation Secondary to Intravitreal Brolucizumab Injection for Neovascular Age-Related Macular Degeneration in a Patient with Cognitive Impairment |
| title_fullStr | Intraocular Inflammation Secondary to Intravitreal Brolucizumab Injection for Neovascular Age-Related Macular Degeneration in a Patient with Cognitive Impairment |
| title_full_unstemmed | Intraocular Inflammation Secondary to Intravitreal Brolucizumab Injection for Neovascular Age-Related Macular Degeneration in a Patient with Cognitive Impairment |
| title_short | Intraocular Inflammation Secondary to Intravitreal Brolucizumab Injection for Neovascular Age-Related Macular Degeneration in a Patient with Cognitive Impairment |
| title_sort | intraocular inflammation secondary to intravitreal brolucizumab injection for neovascular age related macular degeneration in a patient with cognitive impairment |
| topic | age-related macular degeneration AMD intraocular inflammation IOI brolucizumab dementia |
| url | https://www.mdpi.com/1648-9144/59/10/1856 |
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