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William Waldrop, Jessica Nguyen, Chan Nguyen; Survey of bilateral intravitreal injection practices. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2153. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The frequency with which bilateral same-day intravitreal anti-VEGF injections (BSI) are performed is not well known. Furthermore, special techniques for BSI to reduce risk of complications are not universally agreed upon or standardized. We sought to determine present opinion among retina specialists of BSI, how frequently BSI are performed, and what measures are most frequently employed to prevent complications.
An online survey was distributed to retina specialists of the American Society of Retina Specialists and Dallas Academy of Ophthalmology via an online link. A total of 84 respondents completed the survey between March 2 and May 8, 2015.
Of the 82 physicians who perform frequent injections, 66 (80.4%) report performing BSI, with 53 (64.6%) performing at least monthly BSI. While a significant majority of respondents had cared for patients with unilateral endophthalmitis from intravitreal injection (69/82, 84.2%), a more significant majority had not cared for a patient with bilateral endophthalmitis (81/82, 98.8%). Of those who reported using bevacizumab, 66.2% (51/77) reported using a compounding pharmacy accredited by the Pharmacy Compounding Accreditation Board (PCAB). Nearly half of the respondents (30/66, 45.5%) reported not taking any special measures with regards to lot, batch or vial number because the issue had never been raised (19/66, 28.8%) or because of a lack of resources (11/66, 16.7%). A majority of respondents (54/82, 66%) felt that precautions related to lot and batch number were good but not necessary because the risk of bilateral complications is minimal.
BSI are performed frequently among retina specialists and by a higher percentage of retina specialists than previously documented through survey. Despite recent outbreaks linked to compounding of bevacizumab, there remains little consensus in practice about measures used to reduce the risk of bilateral complications, including whether precautions related to medicine lot, batch or vial number are important.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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