If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Bilateral Intravitreal Injections Safe, Convenient for Most Patients With Age-Related Macular Degeneration: Presented at RC2009 By Cameron Johnston NEW YORK -- October 6, 2009 -- Patients receiving bilateral injections of anti-vascular endothelial growth factor (anti-VEGF) inhibitors to treat age-related macular degeneration (AMD) do not face any increased risk of ocular adverse events or systemic adverse events, according to a study presented here at the Retina Congress (RC) 2009. According to Sundeep Dev, MD, University of Minnesota School of Medicine, Minneapolis Minnesota, who presented the findings on October 4, ophthalmologists have typically avoided bilateral dosing of these drugs due to the fear of bilateral ocular complications, which can include infections, uveitis, corneal breakdown, vitreous and subretinal bleeding lens injury, retinal detachment, and ischaemia. However, the logistics and burden of performing monocular injections can be daunting for many patients, according to Dr. Dev. The time and cost of attending a clinic on a monthly basis can be problematic, and patients may also, understandably, be anxious and uncomfortable each time they have to receive another injection. At the same time, physicians themselves are pressed with their own caseloads and therefore, could benefit from having less hectic clinic days, with fewer patients arriving at the same time for their monthly injections. Also, of concern to the patient, Dr. Dev said, successfully treating AMD may require regular injections for an as yet undetermined length of time, In Dr. Dev’s review, 191 patients aged 60 to 95 years received 800 bilateral injections of either bevacizumab (n = 640) or ranibizumab (n = 126), or a monocular injection of each (n = 34) over a 40-month period. Patients were followed for a mean of 15 months (range, 1-41 months) during which all systemic and ocular events were recorded. Adverse events were remarkably few in this cohort, Dr. Dev said. Over the follow-up period, 1 patient developed a case of noninfectious iritis in 1 eye, which resolved without complications. Another patient experienced an increase in hypertension and required modification of the drugs taken to manage this condition. Overall, there were no reported cases of endophthalmitis, retinal detachments, vitreous haemorrhage, or corneal abrasions. No patients died during the follow-up period, and no cases of delayed thromboembolic events were recorded. Importantly, the adverse events that were recorded in this cohort occurred after several injections, so it cannot be said that the patients experienced a negative reaction to a single treatment. Dr. Dev said simultaneous bilateral injections of anti-VEGF drugs appear to be safe and well tolerated and may represent significant time and cost savings for patients and their caregivers. He stressed, however, that patients need to be informed that there could be added risks to the bilateral procedures and informed consent must be obtained. The 2009 Retina Congress is a combined meeting of the American Society of Retina Specialists, the Macula Society, and the Retina Society. [Presentation title: Safety of Outpatient Simultaneous Bilateral Intravitreal Injections of Anti-VEGF Agents for the Management of Neovascular AMD]
|
