Abstract
Purpose :
There has been a rapid rise in the use of intravitreal injections such as anti-vascular endothelial growth factors (anti-VEGF), performed over the past few years for the treatment of ocular neovascular diseases. This study aims to review the systemic and ocular adverse events amongst patients treated at a tertiary eye centre over a period of 8 years and compare the rates to major randomized control trials.
Methods :
A retrospective review of all intravitreal injections of anti-VEGF performed over an 8-year period at a tertiary eye care centre in Singapore was done. We report the frequency of systemic and ocular adverse events and compared it amongst the various anti-VEGF agents.
Results :
A total of 14 001 intravitreal injections were performed on 2225 patients from January 1, 2007 to December 31, 2014, and this included 9992 bevacizumab (71.4%), 3306 ranibizumab (23.6%) and 703 aflibercept (5.0%) injections. The mean age of the patients in the study was 68.5 ± 11.8 years (median 68.0 years, range: 21 to 102 years). There were 1266 male and 959 female patients in this study. The majority of the patients in our study were of Asian descent, with 1715 (77.0%) Chinese, 182 (8.2%) Malay, 182 (8.2%) Indian and 146 (6.6%) of other races. Systemic complications related to treatment were: 26 (1.17%) deaths (from any cause), of which 11 (0.49%) were from fatal thromboembolic events, 7 (0.31%) non-fatal thromboembolic events and 2 (0.09%) serious nonocular hemorrhage. Ocular complications included 1 (0.007%) endopthalmitis, 3 (0.021%) traumatic cataracts and 1 (0.007%) retinal detachment. Overall, there was no statistical significance between rates of thromboembolic events and death between Ranibizumab (Lucentis), Bevacizumab (Avastin) and Aflibercept (Eylea).
Conclusions :
The systemic and ocular complications associated with intravitreal injections among Asian patients at a tertiary eye centre are relatively low, and reflect the safety of the treatments. There is no significant difference between the rates of adverse events between different anti-VEGFs.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.