Résumé
Purpose: To report the incidence, clinical features, potential risk factors, and outcomes of intraocular inflammation (IOI) following brolucizumab in Indian eyes. Methods: All consecutive patients diagnosed with brolucizumab?induced IOI from 10 centers in eastern India between October 2020 and April 2022 were included. Results: Of 758 injections given during the study period across centers, 13 IOI events (1.7%) were recorded attributable to brolucizumab. The IOI occurred after the first dose in two eyes (15%) (median 45 days after brolucizumab), second dose in six eyes (46%) (median = 8.5 days), and third dose (39%) in the remaining five eyes (median 7 days). Reinjections of brolucizumab were administered at a median interval of 6 weeks (interquartile range = 4–10 weeks) in the 11 eyes, where IOI occurred after the second or third dose. Eyes that experienced IOI after the third dose had received a significantly greater number of previous antivascular endothelial growth factor injections (median = 8) compared to those who developed it after the first or second dose (median = 4) (P = 0.001). Anterior chamber cells were seen in almost all eyes (n = 11, 85%), while peripheral retinal hemorrhages were seen in two eyes, and one eye showed branch artery occlusion. Two?thirds of patients (n = 8, 62%) recovered with a combination of topical and oral steroids, while remaining recovered with topical steroids alone. Irreversible visual loss was not seen in any eye, and median vision recovered to pre?IOI levels by 3 months’ time point. Conclusion: Brolucizumab?induced IOI was relatively rare, occurring in 1.7% of eyes, was more common after the second or third injection, especially in those who required frequent reinjections every 6 weeks, and occurred earlier with increasing number of previous brolucizumab injections. Continued surveillance is necessary even after repeated doses of brolucizumab.
Résumé
Purpose: To report the initial experience of managing treatment?resistant and treatment?na飗e eyes with polypoidal choroidal vasculopathy (PCV) by using brolucizumab 6 mg. Methods: This was a retrospective multicentric series of all consecutive eyes with PCV treated with brolucizumab. Treatment resistance was defined as taking at least six prior anti?VEGF injections over the past 1 year and showing persistent disease activity in the form of intra (IRF) or subretinal fluid (SRF) or both. All patients were treated on a pro re nata (PRN) basis and followed up monthly. Retreatment was considered when either SRF or IRF were present at any time point during the study. Results: We included 21 eyes of 21 patients with PCV with a mean age of 65.1 � 9.9 years, of which 16 eyes (76%) were treatment?resistant. The mean follow?up period from receiving the first brolucizumab was 27.3 � 3.3 weeks. Of the 21 eyes, seven eyes (33%) received three injections during follow?up, 13 eyes (62%) received two injections, and one eye received one injection. The mean injection?free interval was 12 � 1.2 weeks. The median pretreatment vision was 0.6 logMAR (IQR = 0.47�logMAR) and improved to 0.3 logMAR (IQR = 0.25�6 logMAR), whereas the mean macular thickness improved from 443 � 60 ?m at baseline to 289 � 25 ?m (P < 0.001) at the last follow?up period. None of the eyes experienced any intraocular inflammation across 48 injection sessions. Conclusion: Brolucizumab is safe and effective in controlling PCV disease in both treatment?resistant and treatment?na飗e eyes
Résumé
Rhinospordiosis, a chronic granulomatous disease of the mucocutaneous tissue, is endemic in India and other parts of South East Asia. It commonly affects the upper respiratory tract, but involvement of other sites has also been reported. A 27-year-old male patient reported with features simulating severe obital cellulitis underwent emergency managemt for his systemic problems. Subsequent CT scan and histopathological examination confirmed the diagnosis of rhinoporidiois. Definitive surgical treatment was done to remove the suspected papillomatous mass which led to marked improvement of the patient.