Brolucizumab-Associated Ocular Complications with Concomitant Sub-Tenon Triamcinolone Acetonide: A Multicenter Retrospective Study

Background/Objectives: Brolucizumab is a potent therapeutic option for neovascular age-related macular degeneration (nAMD), but carries risks of intraocular inflammation (IOI), retinal vasculitis (RV), and retinal vascular occlusion (RO). This study evaluated the occurrence of these adverse events in eyes treated with intravitreal brolucizumab injection (IVBr) under a treatment strategy incorporating sub-Tenon injection of triamcinolone acetonide (STTA). Methods: This multicenter retrospective study included patients with nAMD who initiated IVBr treatment with STTA and were followed for at least 1 month. IVBr was administered under a treatment strategy incorporating STTA, with repeat STTA when more than 3 months had elapsed since the previous STTA. Results: The study included 80 eyes of 80 patients (59 men and 21 women; mean age, 74.5 ± 7.7 years) from 9 institutions. The mean number of previous intravitreal anti-vascular endothelial growth factor injections was 20.4 ± 18.3. The mean follow-up period was 6.8 ± 4.8 months. The mean numbers of IVBr and STTA administrations were 2.6 ± 1.6 and 1.7 ± 1.0 per eye, respectively. Three eyes (3.75%) developed adverse events: one developed IOI, one developed IOI with RV, and one developed RO without IOI or RV. Conclusions: IOI, RV, and RO occurred in 2.5%, 1.25%, and 1.25% of eyes, respectively. These data may help inform the design and sample-size planning of future prospective comparative studies.