Purchase this article with an account.
Inger Westborg, Susanne Albrecht, Gunilla Bjärnhall, Elisabeth Granstam, Ingrid Johansson, Niklas Karlsson; The Swedish Macula Register - results, adverse events and safety in intravitreal injections. Invest. Ophthalmol. Vis. Sci. 2014;55(13):643.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The Swedish Macula Register (SMR) is a national quality register for treatment of age-related maculadegeneration (AMD) established in 2003 and since 2007 are 99% of the treatments intravitreal injections (IVI). SMR analyze results (improvement of vision) related to age, gender, type of lesion, number and type of treatments per clinic/county. Adverse events (AE) are reported to the register . SMR has a coverage of 82%.
AE are registered and a comparison with Medical Products Agency Sweden (MPA) of severe AE has been conducted 2007- 2012. A survey of operative routines of IVI has been sent to all eye clinics in Sweden treating wet AMD november 2013.
SMR december 2013 includes 15305 patients, 17505 eyes, 230205 visits and105325 treatments. Mean age for start of IVI is 79 years of age and 64% of patients are female. Improvement of visual acuity after 12 months of treatment was ≥5 letters for 43% and ≥15 letters for 16% The number of injections in the first year of treatment has increased 2007-2012. During 2007-2011 98% of all IVI were Ranibizumab. Since sep 2011 there is an increase in use of Bevicizumab and 2013 when Aflibercept was introduced it was quickly adapted in Sweden. December 2013 39,6% of all IVI for AMD are Ranibizumab, 25,2% Bevicizumab and 34,5% Aflibercept. The registration of postoperative endophthalmitis 2007-2012 were 23 cases. The incidence has increased 2008 0,25‰ to 2012 0,35‰. Suspected systemic AE has increased 2010-2012 with 6 reported cases 2010 to 48 2012.This is an incidence 2010 of 1,0‰ and 2012 5,73‰ per patient. MPA has received 12 cases of endophthalmitis 2007-2012 and 115 cases of suspected systemic AE. The survey of IVI was answered by 35 of 39 clinics. IVI are performed in operation theatre (92%) and sterile room in office (8%). Antibiotics are used on the day of injection in 32 clinics and only 3 clinics give no antibiotics in IVI with anti-VEGF.
The number of patients, treatments and follow-up visits has increased every year. The incidence of endophthalmitis increased 2007 to 2012. Suspected systemic AE has increased 2010-2012 20 cases has been judged by MPA to have connection with the IVI 40% cardiovascular and 45% cerebrovascular AE. IVI are performed in operation theatre in most eye clinics in Sweden. 90% of clinics give antibiotics in conjunction with IVI. SMR will 2014 start a register for endophthalmitis after IVI.
This PDF is available to Subscribers Only