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Younghoon Lee, Byung Yi Ko; Noninfectious Inflammation after Intravitreal Aflibercept (EYLEA®) Injection for Patient with Exudative Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1443.
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© ARVO (1962-2015); The Authors (2016-present)
To report the clinical features and outcome of noninfectious inflammation after intravitreal aflibercept injection
Retrospective medical records review of patients who presented with noninfectious inflammation after intravitreal aflibercept injection provide 1 clinician between January 1, 2015 and October 31, 2017
The overall incidence of inflammation after intravitreal aflibercept injection was 12 of 839 injections (1.43%) or 8 of 241 patients (3.32%). The patients presented 1–7 days after aflibercept injection (median 3 days); 4 of 8 patients (50%) noted decreased vision and floater, otherwise 4 patients had no symptom. The average anterior chamber cell was 1.5+ (range 0.5+ to 3+) and all eyes had some degree of vitritis (average 1.0+; range 0 to 3+) according to the Standardization of Uveitis Nomenclature grading scheme. 4 patients were switched from ranibizumab(Lucentis®) and another 4 patients were started with aflibercept. Patients on average had received 0.87 prior aflibercept injections (range 0–3). All patients were managed with frequent topical and systemic steroids (prednisolone 20~30mg/day) and were followed closely for signs of improvement. All patients regained their preinjection visual acuity (average: 13 days; range: 7–21 days). And all patients were subsequently rechallenged with aflibercept. Topical and systemic steroids (prednisolone 20mg/day) for 3 days were used as the pretreatment to prevent inflammation after next aflibercept injection. Only 1 patient recurred 5 times. As the injection was repeated, the inflammation of the patient tended to decrease.
Noninfectious inflammation after intravitreal aflibercept injection typically presents with mild inflammatory sign and without pain. And it showed good responds to steroid therapy. Steroid pretreatment might play a role in preventing and reducing the recurrence of post-injection inflammation.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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