DR RUTUJA RAGHVENDRA TALEGAONKAR

DR. LUBHANI JAIN, DR.KULIN J KOTHARI, DR.SHREYAS RANJIT SHAH

Abstract

Presentation:

A 59 yr old male came to us with V/A 6/12 & N12 with PCV diagnosed using ICG & OCT suggestive of Subretinal fluid and intraretinal fluid. He was treated with 3 doses of Intravitreal Bevacizumab 1.25 mg but the V/A remained unchanged & the SRF & IRF was same as before. 1 loading dose of Ranibizumab 0.5 mg was given, after which V/A was 6/18 & SRF & IRF was same as before. 7 doses of Aflibercept 2mg on monthly basis were given following which V/A became CF 1m and OCT findings remained same. He did not show any reponse over a period of time so was treated with IV Brolucizumab 6mg after which gradual improvement was seen. On OCT SRF resolved & IRF reduced & remained dry for 2.5 months. 2 doses of IV Brolucizumab were repeated at 3 months gap on the recurrence of fluid on Pro Re Nata Regimen.

Conclusion: This is a case of refractory PCV that responded to Brolucizumab where treatment extension could be achieved. So IV Brolucizumab can be considered in refractory cases of PCV.