scholarly journals Acute Bacterial Tenonitis and Conjunctivitis following Intravitreal Injection

2021 ◽  
pp. 311-314
Author(s):  
Lillian Y. Huang ◽  
Albert O. Edwards
Keyword(s):  
Injection Site ◽  
Macular Degeneration ◽  
Intravitreal Injection ◽  
Ocular Surface ◽  
Age Related Macular Degeneration ◽  
Topical Antibiotic ◽  
Tenon’S Capsule ◽  
Age Related ◽  
Chemical Irritation ◽  
Tenon's Capsule

A 73-year-old man presented 3 days after intravitreal injection (IVI) with bevacizumab for treatment of neovascular age-related macular degeneration with pain and redness around the injection site. Examination showed conjunctival edema and injection around the injection site and a central infiltrate at the injection site consistent with infection of Tenon’s capsule and the conjunctiva. Infection of a vitreous wick was considered, but vitreous inflammation was not present. Acute bacterial tenonitis and conjunctivitis were diagnosed, and the patient was prescribed topical antibiotic drops. The patient’s symptoms were resolved within 48 h following the use of topical antibiotic drops, so a culture was not performed. The patient did not develop endophthalmitis. To our knowledge, this is the first reported case of acute bacterial tenonitis and conjunctivitis of the injection site following IVI. Even with the use of betadine, infection of Tenon’s capsule and the conjunctiva may occur after IVI and must be differentiated from other causes of postinjection ocular redness such as chemical irritation of the ocular surface, corneal abrasions, and endophthalmitis.

scholarly journals The role of preventive topical antibiotic treatment prior to intravitreal injection

2015 ◽  
Vol 8 (2) ◽  
pp. 79-83 ◽  
Author(s):  
Elena Vladimirovna Ageeva ◽  
Anna Evgen'yevna Grodnenskaya ◽  
Kseniya Aleksandrovna Popova
Keyword(s):  
Macular Degeneration ◽  
Intravitreal Injection ◽  
Staphylococcus Epidermidis ◽  
Povidone Iodine ◽  
Antibiotic Use ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Topical Antibiotic ◽  
Topical Antibiotics ◽  
Age Related

Treatment of wet age-related macular degeneration (AMD) requires frequent intravitreal injections of anti-VEGF agents, sometimes on monthly basis during a long period of time. Endophthalmitis is a rare but extremely severe complication of intravitreal injections. As it has been proven before, the flora from the conjunctival surface is the main source for endophthalmitis. Using Povidone-iodine solution (Betadine10 % Povidone-iodine, EGIS PHARMACEUTICALS) is the only way to prevent endophthalmitis. The efficacy of it was proven by numerous studies. No evidence exists that topical antibiotiotics prior and after injections could be effective for prevention of endophthalmitis. Purpose: To study the advisability of topical antibiotic application before intravitreal injection. Materials and methods: Under investigation, there were 25 eyes of 25 patients with wet AMD treated by anti-VEGF intravitreal injections. All patients used topical antibiotics 3 days before injection. Conjunctival culture from injection eye was collected three times: before topical antibiotic use; after topical antibiotic use, and after Betadine 5 % application. Results: The rates of Staphylococcus epidermidis before and after topical antibiotic use were approximately equal. However there was no Staphylococcus epidermidis found after Betadine 5 % application. Conclusion: Our study showed the effectiveness of Betadine 5 % solution in conjunctival flora reduction. Use of topical antibiotics 3 days prior intravitreal injections is not effective. Key words: age-related macular degeneration; endophthalmitis; intravitreal injection; topical antibiotics; endophthalmitis prevention.

scholarly journals Incidence of elevated intraocular pressure after intravitreal injection in Japanese patients with age-related macular degeneration

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maiko Maruyama-Inoue ◽  
Tatsuya Inoue ◽  
Shaheeda Mohamed ◽  
Yoko Kitajima ◽  
Shoko Ikeda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intraocular Pressure ◽  
Macular Degeneration ◽  
Intravitreal Injection ◽  
Odds Ratio ◽  
Japanese Patients ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Elevated Intraocular Pressure ◽  
History Of

AbstractThe purpose of this study was to report the incidence of elevated intraocular pressure (IOP) after intravitreal injection (IVI) of anti-vascular endothelial growth factor (VEGF) in Japanese patients with age-related macular degeneration (AMD). A retrospective study of chart review of patients who underwent ≥ 10 intravitreal anti-VEGF injections between April 2009 and December 2019 was conducted. Elevated IOP was defined as IOP ≥ 25 mmHg at one visit. Cases with elevated IOP resulting from IVI were identified. Furthermore, the association between elevated IOP and some parameters, as the risk factors that influence elevated IOP, was investigated. A total of 402 eyes of 370 patients were included in this study. Twenty-eight eyes of 26 patients (7.0%) were identified as cases with elevated IOP after IVI. The mean time of elevation after baseline was 50.6 ± 26.5 months. History of glaucoma (p = 0.021; odds ratio, 5.85), treatment modality (p = 0.019; odds ratio, 6.32), and total number of injections (p = 0.003; odds ratio, 1.03) were significantly associated with elevated IOP. A late complication of elevated IOP is associated with IVI in patients with AMD. Particularly, history of glaucoma and treat and extend regimen with frequent injections were found to be risk factors of elevated IOP.

Intravitreal Injection of Ziv-Aflibercept in Patient With Refractory Age-Related Macular Degeneration

2015 ◽  
Vol 46 (1) ◽  
pp. 91-94 ◽  
Author(s):  
João Rafael de Oliveira Dias ◽  
Camilla Oliveira Xavier ◽  
André Maia ◽  
Nilva Simeren Bueno de Moraes ◽  
Carsten Meyer ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Intravitreal Injection ◽  
Age Related Macular Degeneration ◽  
Age Related

scholarly journals Effect of intravitreal injection of aflibercept on blood coagulation parameters in patients with age-related macular degeneration

2020 ◽  
Vol 12 ◽  
pp. 251584142090392
Author(s):  
Constantinos D. Georgakopoulos ◽  
Olga E. Makri ◽  
Athina Pallikari ◽  
Konstantinos Kagkelaris ◽  
Panagiotis Plotas ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Blood Coagulation ◽  
Intravitreal Injection ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Clinical Effects ◽  
Coagulation Parameters ◽  
Age Related ◽  
Increased Risk ◽  
Treatment Naïve

Purpose: Treatment with intravitreal injections of anti-vascular endothelial growth factor agents has been associated with an increased risk of arterial thromboembolic events. The aim of the present pilot study was to assess the effect of a single intravitreal injection of aflibercept on coagulation. Methods: Treatment-naïve patients with age-related macular degeneration ( n = 47), who were scheduled to undergo treatment with intravitreal injections of aflibercept, were enrolled. None of the included patients received any anticoagulation therapy or had a history of a recent arterial thromboembolic event. Blood samples were collected before the first intravitreal injection, and at 7 and 30 days after aflibercept administration. We evaluated coagulation parameters, such as platelet count and plasma fibrinogen and D-dimer levels; functional clotting parameters, such as prothrombin time, international normalized ratio, and activated partial thromboplastin time; and anticoagulant parameters, such as the levels of Proteins S and C. Results: The levels of all of the evaluated biomarkers were within the normal range at baseline and at both the time points throughout the study. No statistically significant changes were observed in any of the measured parameters at 1 week and 1 month after aflibercept administration. Conclusion: A single intravitreal injection of aflibercept in treatment-naïve patients with exudative age-related macular degeneration has no statistically significant effect on blood coagulation parameters for up to 1 month after aflibercept administration. Our results also provide an explorative statistical data, and further studies are required to evaluate any significant clinical effects of aflibercept on blood coagulation parameters. ClinicalTrials.gov ID: NCT03509623.

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