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M. Risco, S. Bakri, A. Edwards, J. Pulido; Safety and Tolerability of Same-Day Bilateral VEGF-A Inhibitor Injections. Invest. Ophthalmol. Vis. Sci. 2009;50(13):51.
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To evaluate the safety and tolerability of bilateral same-day intravitreal injections performed in an office setting.
A retrospective case review was conducted on the medical records of 35 patients who received same-day bilateral intravitreal injections between November 2007 and November 2008. Data collected included details of primary indication for injection therapy, follow-up dates, pre- and post-injection intraocular pressure (IOP), pre- and post-injection visual acuity (VA), and complications/complaints after each injection, if any.
A total of 182 injections were administered on 35 patients, with a mean of 5.2 injections per patient (range: 2 to 14, SD: 3.26). 121 eyes received bevacizumab alone, 13 received bevacizumab plus preservative-free intravitreal triamcinoline or triescence, 44 received ranibizumab and 4 received bevacizumab and dexamethasone. Mean time of post-injection follow up was 37 days (SD: 15). The primary indication for therapy was choroidal neovascularization from age-related macular degeneration (49 eyes); 13 eyes were treated for diabetic macular edema, 4 for proliferative diabetic retinopathy, 2 for macular edema due to retinal vein occlusion, and 2 for other indications. The pre- and post-injection visual acuity was measured after 130 bilateral injection sessions. The mean visual acuity before each injection was 20/150 and mean visual acuity at the next follow-up was 20/100, with no significant difference between the two (p=0.50). 1 patient had a culture-negative endophthalmitis in one eye 3 days after a bilateral injection of bevacizumab.
Same-day bilateral intravitreal injections can be performed in an office setting, and patients should be counseled as to the risk of complications.
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