July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Does repeated intravitreal injections impact the quality of life of patients, about 40 patients?
Author Affiliations & Notes
    69008, Desgenettes military hospital, Lyon, France
    69004, Croix Rousse University Hospital Center, Lyon, France
  • Hussam El Chehab
    69008, Desgenettes military hospital, Lyon, France
  • Romane Chudzinski
    69008, Desgenettes military hospital, Lyon, France
  • Mayeul Chaperon
    69008, Desgenettes military hospital, Lyon, France
  • Antoine Levron
    69008, Desgenettes military hospital, Lyon, France
  • Emilie Agard
    69008, Desgenettes military hospital, Lyon, France
  • Corinne Dot
    69008, Desgenettes military hospital, Lyon, France
  • Footnotes
    Commercial Relationships   SARAH VERRECCHIA, None; Hussam El Chehab, None; Romane Chudzinski, None; Mayeul Chaperon, None; Antoine Levron, None; Emilie Agard, None; Corinne Dot, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4471. doi:
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      SARAH VERRECCHIA, Hussam El Chehab, Romane Chudzinski, Mayeul Chaperon, Antoine Levron, Emilie Agard, Corinne Dot; Does repeated intravitreal injections impact the quality of life of patients, about 40 patients?. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4471.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Intravitreal injections (IVT) are used worldwide to treat age-related macular degeneration, and macular oedema. IVT protocol is standardized and includes use of Betadine® for the infectious endophthalmitis prevention. Patients report symptoms (ocular pain and burning) that appear within hours of injection, which have an impact on their daily activities. We performed a prospective study to learn about changes in the corneal surface and tear film induced by IVT, and impact on quality of life.

Methods : 40 eyes of 40 patients were included, who had unilateral IVT using Ranibizumab, Aflibercept or Dexamethasone, naïve or not. Exclusion criteria were bilateral injections, and the presence of a language barrier. Patients were assessed during two consultations: one before injection, with a clinical exam (presence of keratitis evaluated by Oxford classification), an automated evaluation of corneal surface using Lacrydiag® and the achievement of an OSDI score (ocular surface disease index). These exams were repeated one day after injection, with a pain scale measurement. The primary outcome was the difference in the OSDI score before and after IVT. Secondary outcomes were to determine whether injections impact the ocular surface, comparing the injected eye and the fellow eye (control eye).

Results : Mean age was 76.5 years +/- 2.3 the sex ratio was Men/Women 0.39. Mean change in OSDI score was + 25.5 +/- 1.6 (p= 0.05). Superficial Keratitis was observed in 60% of case in the injected eye, and 10% in the fellow eye (p<0.001). Mean pain scale was 5.5/10 during the day after IVT. The tear film meniscus was lower in the injected eye than in the fellow eye (1.15mm vs 2.30mm) (p=0.05), measures of automated break up time was similar in the two groups. Other measurements made with Lacrydiag® (automated break up time and interferometry in the injected eye/fellow eye) were not statistically significant.

Conclusions : Repeated intravitreal injections induced clinical discomfort in our patients and altered their quality of life by modifying the corneal surface. These side effects could lead to poor compliance and a lack of motivation for these long-term treatments. Lower adherence is associated with worse outcome. We should consider it in the overall management and adapt per and post IVT protocols.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.


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