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Yanping Xu, Colin S Tan; Safety and complications of Intravitreal injections performed over 8 years at a tertiary eye centre in Singapore. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3337. doi: https://doi.org/.
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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.
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.
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).
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.
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