scholarly journals Reflux after intravitreal injection: an anterior segment optical coherence tomography study

2020 ◽  
Vol 10 (1) ◽  
pp. 18-21
Author(s):  
Ismail Ersan ◽  
Aydin Yildiz ◽  
Ismail Ersan ◽  
Aydin Yildiz

Purpose: To investigate the intraocular pressure and conjunctival thickness changes following the intravitreal injection Methods: Sixty eyes of 60 patients having intravitreal injection for age-related macular degeneration, macular edema associated with diabetes, central retinal vein occlusion, and branch retinal vein occlusion were enrolled. Intraocular pressure (IOP) was measured by Tonopen-Avia (Reichert Inc., NY, USA) in sitting position and five superior-temporal conjunctival images were obtained using the Anterior Segment 5 Line Raster scanning protocol of Cirrus HD-OCT 4000 (Carl Zeiss Meditec, Dublin, CA, USA) just before the intravitreal injection. 0.05 ml bevacizumab with 27-gauge needle, 0.05 ml ranibizumab with 30-gauge needle, or dexamethasone implant with 23-gauge needle was injected into the vitreous cavity. The second IOP measurements and OCT measurements were taken within 5 mins of injection. Results: The ranibizumab group included 25 subjects, the bevacizumab group included 23 subjects, and the dexamethasone group included 12 subjects. IOP increases following intravitreal injection were significantly higher in ranibizumab and bevacizumab groups compared with Dexamethasone implant group (p<0.001 and p=0.007, respectively). Although, the increase of conjunctival thickness following the intravitreal injection was highest in Dexamethasone implant group, the differences between the groups did not reach statistically significance (p=0.153). Conclusion: A higher IOP elevation is observed if a small-gauge needle is used for intravitreal injection. The conjunctival thickness changes following the intravitreal injection did not differ between the groups

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maiko Maruyama-Inoue ◽  
Tatsuya Inoue ◽  
Shaheeda Mohamed ◽  
Yoko Kitajima ◽  
Shoko Ikeda ◽  
...  

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.


Author(s):  
Ahmad Mirshahi ◽  
Alireza Lashay ◽  
Hamid Riazi-Esfahani ◽  
Nazanin Ebrahimiadib ◽  
Hassan Khojasteh ◽  
...  

Purpose: To report the results of intravitreal injection of a bevacizumab biosimilar called Stivant®. Methods: This prospective interventional case series was conducted on eyes with neovascular age-related macular degeneration (nAMD), retinal vein occlusion (RVO), and diabetic macular edema (DME). Stivant® was injected in three consecutive months and changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at baseline and monthly up to one month after the third injection. Results: Three hundred and eighty-five eyes with DME (234 eyes, 61%), nAMD (87 eyes, 22%), and macular edema secondary to RVO (64 eyes, 17%) were enrolled. The mean ± standard deviation age of the patients was 61.7 ± 7.20 years. The mean BCVA and CMT changed from 0.63 ± 0.3 to 0.51 ± 0.3 LogMAR (P = 0.12 ) and from 420.4 ± 47.3μm at baseline to 316.7 ± 50.6 μm (P < 0.001) in the DME group; from 0.79 ± 0.3 to 0.68 ± 0.3 LogMAR (P = 0.19) and from 376.1 ± 31.7 μm to 303 ± 31.3 μm (P = 0.019) in the nAMD group; and from 0.81 ± 0.4 to 0.63 ± 0.4 LogMAR (P = 0.05) and from 424.21 ± 18 μm to 303.4 ± 18.8 μm (P < 0.001) in the RVO group, respectively. Conclusion: Our limited experience showed that the intravitreal injection of Stivant® was well tolerated. Although the results of this case series showed relative improvement in CMT one month after the last injection of Stivant®, BCVA improvement was statistically significant only in the RVO group. This would be essential to design a randomized clinical trial to evaluate the non-inferiority of Stivant® in comparison to bevacizumab.


2017 ◽  
Vol 36 (3) ◽  
pp. 224-230 ◽  
Author(s):  
Fernanda Pacella ◽  
Giuseppe La Torre ◽  
Stefania Basili ◽  
Monica Autolitano ◽  
Antonella Pascarella ◽  
...  

2021 ◽  
pp. 145-152
Author(s):  
Rodrigo Vilares-Morgado ◽  
Carolina Madeira ◽  
Ana Maria Cunha ◽  
Manuel Falcão ◽  
João Beato ◽  
...  

<b><i>Purpose:</i></b> The aim of this study was to evaluate whether the coronavirus disease 19 (COVID-19) pandemic resulted in undertreatment and subsequent loss of visual acuity (VA) in patients with macular neovascularization (MNV) or retinal vein occlusion (RVO) regularly treated with intravitreal antivascular endothelial growth factor injections. <b><i>Methods:</i></b> Single-center, retrospective study of patients scheduled for treatment between March 19 and June 1, 2020, the national mandatory quarantine period. Patients’ demographics, VA, and scheduled treatment during this period were reviewed via medical records. All patients were analyzed regarding treatment attendance rates. The visual impact of COVID-19 was assessed in patients who had been treated and presented a stable VA for &#x3e;6 months before the beginning of the quarantine. <b><i>Results:</i></b> This study included 927 eyes from 769 patients. The attendance rate increased throughout the study timeframe (<i>p</i> &#x3c; 0.001) and correlated negatively with higher patient’s age (<i>r</i> = −0.142; <i>p</i> = 0.005). Patients with age-related macular degeneration (67.6%) had lower attendance rates (<i>p</i> = 0.007) and were older (<i>p</i> &#x3c; 0.001). The visual impact analysis included 400 eyes from 325 patients. The average VA variation throughout this period was −1.7 ± 8.4 ETDRS letters and was similar in different retinal pathologies (<i>p</i> = 0.334). VA variation did not correlate with the number of missed treatments per patient (<i>r</i> = 0.100; <i>p</i> = 0.150). The prevalence of subretinal fluid and intraretinal fluid, as well as central retinal thickness decreased significantly throughout the study period (<i>p</i> values of &#x3c;0.001, &#x3c;0.001, and 0.032, respectively). <b><i>Conclusion:</i></b> The COVID-19 pandemic had a significant impact on the attendance rate of patients with MNV or RVO to their scheduled treatments, which was higher in the first week of mandatory quarantine. Nevertheless, VA did not decrease significantly during this period, with a limited VA variation regardless of primary retinal disorder and morphological parameters even improved in the eyes included in the visual impact analysis.


Retina ◽  
2013 ◽  
Vol 33 (6) ◽  
pp. 1099-1108 ◽  
Author(s):  
Timothy L. Jackson ◽  
Elena Nicod ◽  
Aris Angelis ◽  
Federico Grimaccia ◽  
A. Toby Prevost ◽  
...  

2020 ◽  
pp. bjophthalmol-2020-317337
Author(s):  
Thomas Ciulla ◽  
John S Pollack ◽  
David F Williams

Background/AimsTo assess visual acuity (VA) outcomes and antivascular endothelial growth factor (anti-VEGF) therapy intensity in retinal vein occlusion (RVO)-related macular oedema (ME).MethodsA retrospective study was completed in treatment-naïve patients with RVO-related ME from 2013 to 2019, using the Vestrum Health Retina Database.ResultsMean baseline age was 72.4 years and 54% were women. In 6 months, in 8876 eyes with branch retinal vein occlusion (BRVO)-related ME, after a mean of 4.5 anti-VEGF injections, VA increased by 9.4 letters (95% confidence interval (CI) for change in VA +8.94 to +9.78, p<0.001) from a baseline of 55.1 letters. In 6737 eyes with central retinal vein occlusion (CRVO)-related ME, after a mean of 4.6 anti-VEGF injections over 6 months, VA improved by 9.2 letters (95% CI +8.50 to +9.87, p<0.001) from a baseline of 37.2 letters. In 1 year, VA gain was similar (BRVO: 7.4 injections, +8.1 letters, 95% CI +7.55 to +8.57, p<0.001; CRVO: 7.6 injections, +7.1 letters, 95% CI +6.31 to +7.95, p<0.001). In 6 months and 1 year, mean letters gain increased with number of anti-VEGF injections. Patient eyes with baseline VA of 20/40 or better tended to lose VA in 1 year.ConclusionMean change in VA correlates with treatment intensity, but patients with better VA at presentation are susceptible to vision loss, reflecting a ceiling effect. Assessed with the same database, VA gains compare favourably with 1-year VA gains in neovascular age-related macular degeneration and diabetic ME, but exhibit a larger gap when compared with corresponding randomised controlled trials.


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