Background/Objectives: Brolucizumab is a humanized single-chain antibody fragment with a molecular weight of approximately 26 kilodaltons (scFv, ~26 kDa) targeting all VEGF-A isoforms. Intravitreal brolucizumab (6 mg) is FDA-approved for neovascular age-related macular degeneration (nAMD) (2019) and diabetic macular edema (DME) (2022). We systematically review the literature on brolucizumab for nAMD and DME, focusing on efficacy, safety, pharmacokinetics, real-world outcomes, and cost-effectiveness in adult and pediatric patients. Methods: Our method involves a comprehensive literature search of PubMed, Embase, Scopus, Cochrane, and related databases (through late 2024) using terms including “brolucizumab,” “Beovu,” “neovascular AMD,” “diabetic macular edema,” “safety,” “pharmacokinetics,” and “pediatric.” High-quality clinical trials, meta-analyses, regulatory documents, and real-world studies were prioritized. Results: In pivotal Phase III trials (HAWK/HARRIER for nAMD), brolucizumab 6 mg demonstrated non-inferior visual acuity (VA) gains to aflibercept, with >50% of eyes maintained on 12-week dosing and greater retinal fluid reduction. In DME trials (KESTREL/KITE), brolucizumab was similarly non-inferior to aflibercept for VA and showed superior anatomic drying, with 33–48% of eyes maintained on ≥12-week intervals. However, brolucizumab use has been associated with intraocular inflammation (IOI), retinal vasculitis, and vascular occlusion: clinical trials and post hoc analyses reported higher rates of these events than comparator agents. Real-world cohorts found IOI in ~4–10% of treated eyes, often occurring early (within 3 months) after initiation. Conclusions: In conclusion, Brolucizumab is an effective anti-VEGF option for nAMD and DME, providing durable anatomic control with fewer injections. Non-inferior vision outcomes and superior fluid resolution have been demonstrated. However, it carries a distinct risk of IOI and occlusive vasculitis, necessitating careful patient selection, dosing, and monitoring.

Gene therapy has emerged as a promising treatment for several eye diseases since it may restore vision and stop blindness. Many eye diseases, including retinitis pigmentosa and macular degeneration, have historically been rather difficult to treat and usually cause permanent vision loss. However, thanks to advances in gene therapy, many disorders can now be effectively targeted and genetically changed, providing a safer, more direct, maybe even curative approach. By introducing, altering, or repairing specific genes inside the eye, gene therapy seeks to fix the defective genes causing these disorders, thereby improving general eye health and visual ability. Voretigene neparvovec is one FDA- and EMA-approved treatment for RPE65 mutations. Retinitis pigmentosa, age-related macular degeneration, X-linked retinoschisis, choroideremia, and Stargardt disease are among the several eye disorders still under clinical trials, and experimental treatment is in progress. As research on gene therapy develops, it opens the path for groundbreaking treatments that could fundamentally change the ophthalmic care scene.

This retrospective multicenter cohort study aimed to describe the clinical features and report the outcomes of the management of ocular syphilis in Saudi Arabia. Thirty-three eyes of 19 patients with ocular syphilis were reviewed, including data on visual acuity, signs of anterior and posterior uveitis, systemic work-up, and treatment outcomes. A total of 38 eyes from 19 patients were examined, with 33 eyes showing manifestations of ocular syphilis. The majority of patients (89.5%; n = 17) were males, with an average age of 40.6 ± 12 years. About one half of the patients (52.6%; n = 10) reported previous unprotected sexual encounters, and 26.3% had positive human immunodeficiency virus (HIV) testing. Systemic manifestations of syphilis were observed in 68.4% of the patients. Fourteen patients (73.7%) had bilateral disease. At presentation, the average Log MAR visual acuity was 0.81 ± 0.80 (Snellen equivalent = 20/120). Anterior chamber inflammation was seen in 72.7% of eyes (n = 28 eyes), while posterior segment examination revealed vitritis in 48.5% (n = 18 eyes), hyperemic optic discs in 62.5% (n = 24 eyes), and vascular sheathing in 46.9% (n = 17 eyes). Placoid lesions were observed in 51.5% of eyes (n = 20 eyes). The most common ocular syphilitic phenotypes were acute syphilitic posterior placoid chorioretinitis (ASPPC) in 54.5% of eyes (n = 21 eyes) and necrotizing retinochoroiditis in 15.2% (n = 6 eyes). Treatment included intravenous penicillin G for 14 days in 12 patients, intramuscular penicillin G in 2 patients, and systemic ceftriaxone in 2 patients. All treated patients showed clinical improvement, with a mean follow-up duration of 6.5 ± 4.5 weeks and a significant improvement in mean Log MAR visual acuity to 0.23 ± 0.46 (Snellen equivalent = 20/30; P < 0.001). These findings highlight the emergence of ocular syphilis in Saudi Arabia and the need for ophthalmologists to recognize its diverse clinical and multimodal retinal imaging features to ensure timely diagnosis and treatment.