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With great excitement, we read the original article titled “Short-term real-world outcomes following intravitreal brolucizumab for neovascular AMD: SHIFT study” by Bulirsch et al.1 We congratulate the authors on their detailed analysis and on adding another important real world data related to brolucizumab usage. As we are still trying to understand the pathogenesis of brolucizumab related immunogenicity and the population at risk,2-4 it would be very helpful for the readers if the authors could share the following information.
1. Were the 7 eyes in which IOI was recorded have history of any other autoimmune systemic diseases such as arthritis, thyroid abnormalities etc ?
2. It would be helpful if the authors could clarify if the 4 eyes that had intermediate uveitis and vitreous cells underwent fluorescein angigraphy or wide filed imaging to rule out the possibility of peripheral retinal vasulilits.
3. It would be helpful for the readers if we could know the indication of using subconjunctival dexamethasone in four cases?
4. After treatment, were all the patients who had vitritis completely free of cells/inflammation on clinical examination or were they asymptomatic?
Ashish Sharma, Nilesh Kumar, Nikulaa Parachuri
Lotus Eye Hospital and Institute, Coimbatore, TN, India
1. Bulirsch LM, Saßmannshausen M, Nadal J, et al Short-term real-world outcomes following intravitreal brolucizumab for neovas...
1. Bulirsch LM, Saßmannshausen M, Nadal J, et al Short-term real-world outcomes following intravitreal brolucizumab for neovascular AMD: SHIFT study British Journal of Ophthalmology Published Online First: 12 April 2021. doi: 10.1136/bjophthalmol-2020-318672
2. Sharma A, Kumar N, Parachuri N, Singh S, Bandello F, Regillo CD, Boyer D, Nguyen QD. Understanding Retinal Vasculitis Associated with Brolucizumab: Complex Pathophysiology or Occam's Razor? Ocul Immunol Inflamm. 2021 May 20:1-3. doi: 10.1080/09273948.2021.1897628.
3. Singer M, Albini TA, Seres A, Baumal CR, Parikh S, Gale R, Kaiser PK, Lobach I, Feltgen N, Joshi MR, Ziemssen F, Bodaghi B. Clinical Characteristics and Outcomes of Eyes with Intraocular Inflammation after Brolucizumab: Post Hoc Analysis of HAWK and HARRIER. Ophthalmol Retina. 2021 May 7:S2468-6530(21)00162-7. doi: 10.1016/j.oret.2021.05.003.
4. Sharma A, Kumar N, Parachuri N, Kuppermann BD, Bandello F, Regillo CD, Boyer D, Nguyen QD. Brolucizumab-foreseeable workflow in the current scenario. Eye (Lond). 2021 Feb 2. doi: 10.1038/s41433-020-01324-w.