Bilateral Anterior Segment Hyphema and Ocular Hypotony Following Treatment with Lutetium (177Lu) Vipivotide Tetraxetan (Pluvicto).

PURPOSE: We describe a case of severe bilateral anterior segment neovascularization leading to hyphema in a patient treated with Lutetium (177Lu) vipivotide tetraxetan for metastatic castration-resistant prostate cancer (mCRPC).

METHODS

Case report with multimodal imaging.

RESULTS

A 77-year-old patient was referred for evaluation of a two-day history of blurry vision. At presentation, the exam was significant for bilateral hyphema, elevated intraocular pressure, and significant microcystic edema. Gonioscopy revealed neovascularization of the anterior segment. Multimodal imaging revealed intraretinal hemorrhages without neovascular retinopathy, metastases, or carotid occlusive disease. The patient was treated medically, but developed significant hypotony necessitating postponement of therapy.

CONCLUSION

This case demonstrates a potential ocular adverse reaction to Lutetium (177Lu) vipivotide tetraxetan therapy.