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https://hdl.handle.net/20.500.14094/0100489207
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2024-07-03
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0100489207 (fulltext)
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3.35 MB
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メタデータID
0100489207
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open access
出版タイプ
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タイトル
Angiographic findings before and after the onset of brolucizumab-associated retinal vascular occlusion and intraocular inflammation
著者
Kusuhara, Sentaro ; Kim, Kyung Woo ; Miki, Akiko ; Nakamura, Makoto
著者ID
A1380
研究者ID
1000040437463
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail.html?systemId=32b946773fbb21da520e17560c007669
著者名
Kusuhara, Sentaro
楠原, 仙太郎
クスハラ, センタロウ
所属機関名
医学研究科
著者名
Kim, Kyung Woo
著者ID
A1504
研究者ID
1000010726988
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail.html?systemId=704fe343d155a8da520e17560c007669
著者名
Miki, Akiko
三木, 明子
ミキ, アキコ
所属機関名
医学部附属病院
著者ID
A0882
研究者ID
1000080273788
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail.html?systemId=82142348522a81ad520e17560c007669
著者名
Nakamura, Makoto
中村, 誠
ナカムラ, マコト
所属機関名
医学研究科
収録物名
American Journal of Ophthalmology Case Reports
巻(号)
26
ページ
101521
出版者
Elsevier
刊行日
2022-04-15
公開日
2024-04-26
抄録
【Purpose】 To describe angiographic features of a case of delayed-onset retinal vascular occlusion and intraocular inflammation (IOI) following brolucizumab intravitreal injection (IVI). 【Observations】 A 75-year-old woman with advanced age-related macular degeneration (AMD) complained of persistent distorted vision despite 1 aflibercept 2-mg IVI and subsequent 1 brolucizumab 6-mg IVI. At 20 days after brolucizumab IVI, clinical examination showed no signs of IOI, her right best-corrected visual acuity (BCVA) was 1.0 (Snellen equivalent, 20/20). Simultaneous fluorescein and indocyanine green angiography (FA/IA) performed 2 days later showed no abnormalities, but she noticed floaters and decreased vision in her right eye 5–6 hours after FA/IA. At 44 days after brolucizumab IVI, her right BCVA was 0.6 (Snellen equivalent, 20/33), and clinical examination revealed mutton-fat keratic precipitates, anterior chamber cells (2+), vitreous cells, vitreous haze (1+), and sheathed retinal vessels. FA showed filling defect and vascular staining/leakage at several retinal arteries and dye leakage from optic disc edge, where IA demonstrated dye staining as well. However, there was a retinal artery occlusion site which lacks angiographic signs indicative of active retinal vasculitis. The patient was diagnosed with retinal vascular occlusion and IOI which occurred approximately 3 weeks after brolucizumab IVI. 【Conclusions and importance】 Delayed brolucizumab-associated retinal vascular occlusion and IOI can develop from a condition in which no apparent abnormal findings exist on FA/IA. Together with the fact that angiographic signs observed in this case were not severe enough to induce retinal artery occlusion, potent and prolonged vascular endothelial growth factor inhibition by brolucizumab IVI might have caused severe damage to retinal vascular endothelial cells. Then, the damage subsequently led to retinal vascular occlusions and enhanced immune reaction to brolucizumab. The latter would be enhanced through the migration of immune cells towards vitreous cavity being allowed by disrupted inner blood retinal barrier.
キーワード
Brolucizumab
Retinal vascular occlusion
Intraocular inflammation
Fluorescein angiography
Indocyanine green angiography
カテゴリ
医学研究科
医学部附属病院
学術雑誌論文
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© 2022 The Authors.
Creative Commons Attribution 4.0 International license
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資源タイプ
journal article
言語
English (英語)
eISSN
2451-9936
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関連情報
DOI
https://doi.org/10.1016/j.ajoc.2022.101521
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