Short-term outcomes following treatment of recalcitrant cystoid macular edema secondary to radiation maculopathy using intravitreal brolucizumab

PURPOSE: To assess the efficacy of intravitreal brolucizumab (Beovu®, Novartis Pharmaceuticals) in a case of recalcitrant cystoid macular edema associated with radiation maculopathy secondary to retinoblastoma which was suboptimally responsive to other intravitreal anti-vascular endothelial growth factor (VEGF) therapies. OBSERVATIONS: A 42-year old patient with a history of radiation maculopathy complicated by cystoid macular edema after chemoreduction treatment and radiation therapy for retinoblastoma was treated with intravitreal brolucizumab. Best-corrected visual acuity and central macular thickness assessed by optical coherence tomography were used to assess the clinical outcomes. The treated eye was also assessed for evidence of intraocular inflammation following injection. Cystoid macular edema showed marked reduction and near resolution two weeks after injection and improvement in best-corrected visual acuity which was maintained for 2 months of follow-up. No ocular inflammatory reactions or other adverse events were reported. CONCLUSIONS AND IMPORTANCE: This case of radiation maculopathy refractory to other intravitreal anti-VEGF treatments showed good treatment response to brolucizumab therapy.