{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T20:34:43Z","timestamp":1777062883853,"version":"3.51.4"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Soonchunhyang University Research Fund","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>To report a case of central retinal artery occlusion (CRAO) after intravitreal injection of brolucizumab for a treatment-na\u00efve neovascular age-related macular degeneration (nAMD) patient without comorbid cardiovascular disease history.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 79-year-old Asian male without a cardiovascular disease history such as diabetes or hypertension underwent three times of monthly consecutive intravitreal brolucizumab injections for treatment of progressed nAMD in his left eye. Two days after the third injection, the patient presented with acute painless visual loss. Typical retinal whitening with a cherry red spot was observed on the fundus photograph, and retinal swelling with hyper-reflectivity was also identified on the optical coherence tomography (OCT) scan. On the fundus fluorescein angiography, arm-to-retina time and arteriovenous transit time were remarkedly delayed, but clinical findings suggesting an intraocular inflammation (IOI) were not observed. Therefore, CRAO was diagnosed, and anterior chamber paracentesis was administrated immediately. However, there had been no improvement in visual acuity during the follow-up period of three months, despite prolonged oral steroid and anti-platelet agent medication.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In rare cases, patients without cardiovascular comorbidities can develop CRAO after intravitreal brolucizumab injection without gross evidence of IOI. Therefore, CRAO should always be in consideration and careful observation is required after intravitreal brolucizumab injection for nAMD patients with old age, even if the patient does not have any other cardiovascular disease history.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12886-024-03452-3","type":"journal-article","created":{"date-parts":[[2024,4,28]],"date-time":"2024-04-28T23:02:02Z","timestamp":1714345322000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Central retinal artery occlusion after intravitreal brolucizumab injection for treatment-na\u00efve neovascular age-related macular degeneration; a case report"],"prefix":"10.1186","volume":"24","author":[{"given":"Sung Hwa","family":"Hong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8353-1656","authenticated-orcid":false,"given":"Hoon Dong","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"key":"3452_CR1","first-page":"3025","volume":"53","author":"J Gaudreault","year":"2012","unstructured":"Gaudreault J, Gunde T, Floyd HS, et al. Preclinical pharmacology and safety of ESBA1008, a single-chain antibody fragment, investigated as potential treatment for age-related macular degeneration. Invest Ophthalmol Vis Sci. 2012;53:3025.","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"5","key":"3452_CR2","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1016\/j.ophtha.2015.12.030","volume":"123","author":"FG Holz","year":"2016","unstructured":"Holz FG, Dugel PU, Weissgerber G, et al. Single-chain antibody fragment VEGF inhibitor RTH258 for Neovascular Age-Related Macular Degeneration: a randomized controlled study. Ophthalmology. 2016;123(5):1080\u20139.","journal-title":"Ophthalmology"},{"issue":"7","key":"3452_CR3","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1016\/j.ophtha.2019.12.031","volume":"127","author":"QD Nguyen","year":"2020","unstructured":"Nguyen QD, Das A, Do DV, et al. Brolucizumab: evolution through preclinical and clinical studies and the implications for the management of Neovascular Age-Related Macular Degeneration. Ophthalmology. 2020;127(7):963\u201376.","journal-title":"Ophthalmology"},{"issue":"1","key":"3452_CR4","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.ophtha.2020.06.028","volume":"128","author":"PU Dugel","year":"2021","unstructured":"Dugel PU, Singh RP, Koh A, et al. HAWK and HARRIER: ninety-six-week outcomes from the phase 3 trials of brolucizumab for neovascular age-related macular degeneration. Ophthalmology. 2021;128(1):89\u201399.","journal-title":"Ophthalmology"},{"issue":"9","key":"3452_CR5","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1038\/s41433-020-0888-y","volume":"34","author":"A Sharma","year":"2020","unstructured":"Sharma A, Parachuri N, Kumar N, et al. Brolucizumab-another anti-VEGF or beyond. Eye (Lond). 2020;34(9):1499\u2013500.","journal-title":"Eye (Lond)"},{"key":"3452_CR6","doi-asserted-by":"publisher","first-page":"1625","DOI":"10.2147\/OPTH.S169143","volume":"12","author":"S Kiss","year":"2018","unstructured":"Kiss S, Dugel PU, Khanani AM, et al. Endophthalmitis rates among patients receiving intravitreal anti-VEGF injections: a USA claims analysis. Clin Ophthalmol. 2018;12:1625\u201335.","journal-title":"Clin Ophthalmol"},{"key":"3452_CR7","doi-asserted-by":"publisher","first-page":"2791","DOI":"10.2147\/OPTH.S425709","volume":"17","author":"NJ Saba","year":"2023","unstructured":"Saba NJ, Walter SD. Efficacy, Safety, and durability of Brolucizumab: an 8-Month Post-marketing Surveillance Analysis. Clin Ophthalmol. 2023;17:2791\u2013802.","journal-title":"Clin Ophthalmol"},{"issue":"4","key":"3452_CR8","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1177\/2474126420930863","volume":"4","author":"AJ Witkin","year":"2020","unstructured":"Witkin AJ, Hahn P, Murray TG, et al. Occlusive retinal vasculitis following Intravitreal Brolucizumab. J Vitreoretin Dis. 2020;4(4):269\u201379.","journal-title":"J Vitreoretin Dis"},{"key":"3452_CR9","doi-asserted-by":"publisher","first-page":"101521","DOI":"10.1016\/j.ajoc.2022.101521","volume":"26","author":"S Kusuhara","year":"2022","unstructured":"Kusuhara S, Kim KW, Miki A, Nakamura M. Angiographic findings before and after the onset of brolucizumab-associated retinal vascular occlusion and intraocular inflammation. Am J Ophthalmol Case Rep. 2022;26:101521.","journal-title":"Am J Ophthalmol Case Rep"},{"issue":"6","key":"3452_CR10","doi-asserted-by":"publisher","first-page":"e938","DOI":"10.1111\/aos.14058","volume":"97","author":"X Gao","year":"2019","unstructured":"Gao X, Borkar D, Obeid A, et al. Incidence of retinal artery occlusion following intravitreal antivascular endothelial growth factor injections. Acta Ophthalmol. 2019;97(6):e938\u20139.","journal-title":"Acta Ophthalmol"},{"issue":"8","key":"3452_CR11","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1038\/nrclinonc.2009.94","volume":"6","author":"HX Chen","year":"2009","unstructured":"Chen HX, Cleck JN. Adverse effects of anticancer agents that target the VEGF pathway. Nat Rev Clin Oncol. 2009;6(8):465\u201377.","journal-title":"Nat Rev Clin Oncol"}],"container-title":["BMC Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12886-024-03452-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12886-024-03452-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12886-024-03452-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,28]],"date-time":"2024-04-28T23:02:51Z","timestamp":1714345371000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcophthalmol.biomedcentral.com\/articles\/10.1186\/s12886-024-03452-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,29]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3452"],"URL":"https:\/\/doi.org\/10.1186\/s12886-024-03452-3","relation":{},"ISSN":["1471-2415"],"issn-type":[{"value":"1471-2415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,29]]},"assertion":[{"value":"20 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted ethically following the World Medical Association Declaration of Helsinki. This study protocol was reviewed and approved by the Institutional Review Board (IRB) of Soonchunhyang University Cheonan Hospital (IRB approval No. 2023-11-058).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"200"}}