DR. SRISHTI KHULLAR

DR.SANJAY KUMAR MISHRA, DR. PRADEEP KUMAR, DR. ALOK SATI

Abstract

80 year old female with Neovascular age related degeneration with treatment naïve macula was treated with intravitreal Brolucizumab 6.0 mg. Her pre-injection BCVA was RE 3/60 and LE 2/60. RE showed a type I CNVM with SRHM, SRF & IRF. LE showed SRHM with hyperreflective foci. Central Macular Thickness was RE 336 microns and LE 274 microns. On FFA the RE showed a classic CNVM & LE showed an occult CNVM pattern. The ICGA showed a hot spot in RE. 4 weeks post injection review showed BCVA RE of 6/60 and LE 5/60 and the OCT of RE showed disappearance of SRF and reduction in IRF. Interestingly the CMT showed reduction to 222 microns in RE and 198 microns in LE. We presume that the effect in the contralateral eye was due to systemic circulation of the intravitreal Brolucizumab as there has been no other intervention in the LE to explain the improvement in vision. We wish to discuss the available literature and scientific evidence of this phenomenon.