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Saloomeh Saati, Jeffrey S Tran, Jesse berry; Ocular and systemic complications after resident intravitreal injection of bevacizumab (Avastin) at Los Angeles County + University of Southern California (LAC+USC) Medical Center.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4178.
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© ARVO (1962-2015); The Authors (2016-present)
To report the rate of complications after intravitreal injection of Avastin in Los Angeles county hospital as a teaching institution in 6 months.
The authors performed a retrospective review of patients’ charts treated with intravitreal injection of bevacizumab (Avastin) between October 2013 and March 2014 in the comprehensive ophthalmology teaching clinic at LAC+ USC medical center.
This study included 593 intravitreal injections in 212 eyes (317 in right eyes and 276 in left eyes). Of the 153 patients 83 (54.2 %) were males and 70 (45.8%) were females. Most commonly presenting ethnicity was Hispanic 127 (83.01 %) followed by Asian 12 ( 7.84 %), Caucasian 10 (6.54%) and African-American 4 (2.61%). Mean age was 58.5 years (range between 30 to 83 years). Each eye was received between 1 to 9 injections. Injections were given by second and third year residents. Mean follow-up time was 5.6 months (range between 0 to 12 months). Most common indication for intravitreal Avastin injections was diabetic macular edema (87.2 %), followed by neovascular age-related macular degeneration ( NVAMD) (5.9 %), macular edema secondary to retinal vein occlusion ( 3.4 %), Choroidal neovascularization with different etiologies other than NVAMD (2%), neovascular glaucoma ( 0.8%) and others (0.7%).The most frequently presenting ocular complication was transient rise of intraocular pressure above 21 mmHg in 221 patients (35.58 %), followed by vitreous hemorrhage in 3 patients (0.5 %). The other ocular side effects registered were one case of uveitis (0.16 %), two cases of newly developed tractional retinal detachment (0.33 %) and one case of hyphema (0.16 %) . Endophthalmitis, traumatic cataract or rhegmatogenous retinal detachment have not been noted. Among the systemic complications were acute rise of blood pressure in one case (0.16 %), nausea in two cases (0.33 %) and dizziness in one case (0.16 %).
Intravitreal Avastin injection is generally a safe treatment for ocular pathologies and can be safely injected by residents in teaching institutions. The overall complication rates in our center as a teaching institution were similar to previous reports in literature.
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