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Saghar Bagheri, Ismini Koulouri, Eleni Konstantinou, Feyza Erenler, Demetrios G. Vavvas; Visual Outcome of Bilateral Same-Session Intravitreal Anti-VEGF Injections. Invest. Ophthalmol. Vis. Sci. 2018;59(9):835.
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To evaluate the visual outcome of bilateral same-session injections of intravitreal anti-vascular endothelial growth factor (anti-VEGF).
This is a cross-sectional retrospective review of all patients that received same-session bilateral intravitreal anti-VEGF injections in one of our clinics between January 15, 2009 and May 16, 2017. All injections were administered by one ophthalmologist (DGV) according to a defined protocol. Visual outcome, indication for injections, patient demographics and post-injection complications were recorded. Sub-group analyses were performed in patients with diabetic macular edema (DME), neovascular age-related macular degeneration (nAMD) and retinal vein occlusion (RVO) to assess for differences in outcome measures.
During the study period, a total of 262 patients received intravitreal injections in one of our clinics, 99 patients for nAMD, 81 patients for DME and 45 patients for RVO. A total of 732 bilateral injections were performed on 73 of these 262 patients: 332 bilateral injections for nAMD (27 patients), 357 for DME (40 patients) and 27 for RVO (4 patients). 52.1 % of patients who received bilateral injections were female. Median age at the time of the first bilateral injection was 65 ± 16.29 (range, 22-95) years. The median number of bilateral injections per patient was 7 ± 8.63 (range, 1-54). The injected anti-VEGF agents were ranibizumab, aflibercept and bevacizumab. Median follow-up period was 1185 ± 787 (range, 49-3008) days. The median best-corrected visual acuity (BCVA) at the 1st bilateral injection visit was 20/64 (range, 20/20-20/20000) OD and 20/80 (range, 20/20-20/8000) OS (Figure). The median BCVA at 1st follow-up after the last bilateral injection was 20/70 (range, 20/16-20/20000) OD and 20/60 (range, 20/15-20/8000) OS. The median BCVA at the last follow-up was 20/70 (range, 20/20-20/20000) OD and 20/60 (range, 20/20-20/8000) OS.
In patients with bilateral same-session anti-VEGF injections, visual acuity remained stable in both eyes over a median follow-up period of more than three years. No cases of endophthalmitis, retinal detachment or other serious complications occurred in this cohort. These data support bilateral same-session injections as a safe and valid treatment in our clinical practice to preserve visual acuity in patients with bilateral disease.
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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