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Elizabeth Atchison, Sophie J Bakri, Ahmed F Omar; Outcomes of an intravitreal injection clinic. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3346.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the safety outcomes of an intravitreal injection only clinic where patients needing chronic anti-VEGF therapy are treated with injections at a predetermined interval for a set number of injections without an accompanying clinic visit.
A retrospective chart review of all patients with exudative macular degeneration treated in an intravitreal injection clinic over a 6 year period. Data on the date, injected drug, laterality, whether it was part of a pre-assigned cycle and whether it was an injection-only visit or in conjunction with a clinic visit was recorded for each injection. For every patient with an interruption of an injection cycle the reason the cycle was discontinued was gathered from the chart. For each patient requiring an urgent (non-routinely scheduled) clinic visit, diagnoses made at such visits was recorded. All patients who changed laterality of treatment or who went from treating one eye to both eyes had their charts reviewed for new diagnosis of exudative AMD in the fellow eye.
556 patients received 4386 injections in the injection only clinic in a total of 1524 injection cycles. 106 cycles (74) were interrupted. The most common causes for interruption were: 32 for decreased vision in the injected eye, 23 for decreased vision in the fellow eye, 6 for flashing, 5 for pain, and 2 for irritation in the non-injected eye. Of patients who had an interruption of the cycle, 32 had a new diagnosis (most common: 6 abrasions, 6 exudative AMD in fellow eye). Of those with a diagnosis of exudative AMD in the fellow eye on an urgent visit, 3 had a sudden vision change within one week of being seen, 1 had 10 days of symptoms, 1 had 3 weeks of symptoms and one did not have a date of sudden change recorded. Four patients had been seen with a full clinic and OCT visit less than 1 month before. There were 6 instances of conversion to exudative AMD found in the other eye at a routine follow up visit following injection clinic. Five of these were 3 months after the last full exam with OCT and 1 was 5 months from the last exam with OCT.
An injection only clinic may provide a reasonable approach to streamline retina practices.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Reasons for interrupted cycles
Diagnoses on urgent visits
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