Purpose:To report short-term efficacy of brolucizumab injection in treatment-naïve large pigment epithelial detachment secondary to neovascular age-related macular degeneration.Case Summary: A 63-year-old male presented with decreased visual acuity in the left eye. He was diagnosed with neovascular age-related macular degeneration accompanied by large pigment epithelial detachment (PED), with central retinal thickness (CRT) of 641 µm and best-corrected visual acuity (BCVA) of 0.3 (decimal). Two months later, without treatment, the PED had worsened, with CRT of 782 µm and BCVA of 0.2. Considering the rapid progression of the PED and the deterioration in visual acuity, intravitreal brolucizumab injection was administered. One month after the injection, significant improvement was observed, with CRT of 246 µm and BCVA of 1.0. The improvement was maintained at the three-month follow-up, with resolution of the PED and subretinal fluid and sustained BCVA of 1.0.No ocular inflammation or occlusive retinal vasculitis was observed during follow-up.

Conclusions:This case demonstrates the short-term efficacy of brolucizumab injection in a treatment-naïve patient with neovascular age-related macular degeneration, presenting with a rapidly progressing large pigment epithelial detachment and associated visual loss.