Correspondence

Gy, Shah; Ambatipudi, Srinivas; Fernandes, Merle; M, Lakshmipathy; Pv, Varma; Sachdeva,; Pathengay, Avinash

doi:10.1097/iae.0b013e3181e7985c

Cited by 2 publications

(1 citation statement)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869] The years between 2007-10, being populated largely by case reports and occasional case series detailing the use of anti-VEGF agents in treating CNVM of other etiology, and retinopathy of prematurity[41] (2007), AMD[3] and adjunct to trabeculectomy[44] (2008). We can see a trend towards randomized case-control studies comparing different anti-VEGF agents, the use of combination treatments in AMD and other diseases since 2011 onwards.…”

Section: Resultsmentioning

confidence: 99%

Changing paradigms of anti-VEGF in the Indian scenario

Shanmugam

2014

Indian J Ophthalmol

View full text Add to dashboard Cite

Anti-vascular endothelial growth factors (VEGF) agents have revolutionized the treatment of retinal diseases. Use of anti-VEGF agents in the Indian Scenario present some unique challenges considering the absence of compounding pharmacies, poor penetrance of health insurance and limited affordability of the citizens of a developing economy. To study the changing paradigms of anti-VEGF use in the Indian scenario, all articles published by Indian authors, data from web-based surveys amongst Indian vitreo-retinal specialists were reviewed. In the paucity of compounding pharmacies in India, fractionation and injection techniques differ from those of developed countries. Frequent anti-VEGF monotherapy offers the best anatomical and visual results, but economics of scale do not allow the same in the Indian scenario, resulting in PRN dosing and combination of anti-VEGF with laser photocoagulation, being the commonly employed treatment protocols.

show abstract

Section: Resultsmentioning

confidence: 99%

Changing paradigms of anti-VEGF in the Indian scenario

Shanmugam

2014

Indian J Ophthalmol

View full text Add to dashboard Cite

show abstract

Endophthalmitis following intravitreal anti-vascular endothelial growth factor (VEGF) injection: a comprehensive review

Merani

Hunyor

2015

Int J Retin Vitr

View full text Add to dashboard Cite

The purpose of this review is to report and summarize previously reported studies and assess many of the individual steps of the intravitreal injection procedure’s possible effect on the prevention of endophthalmitis. The pooled endophthalmitis rate from 20 large retrospective case series of anti-VEGF injections was 144/510,396 (0.028%; 1/3,544). Injections may be performed in an office-based location or in an operating room (OR) and low rates of endophthalmitis can be achieved in either location with careful attention to asepsis. Pre- or post-injection topical antibiotics have not been shown to be effective, and could select for more virulent microorganisms. Povidone-iodine prior to injection is accepted as the gold-standard antiseptic agent, but aqueous chlorhexidine may be an alternative. Antisepsis before and after gel or subconjunctival anesthetic is suggested. The preponderance of Streptococcal infections after intravitreal injection is discussed, including the possible role of aerosolization, which can be minimized by using face masks or maintaining silence. As with other invasive procedures in medicine, the use of sterile gloves, following adequate hand antisepsis, may be considered. Control of the eyelashes and lid margin is required to avoid contamination of the needle, but this can be achieved with or without a speculum. Techniques to minimize vitreous reflux have not been shown to reduce the risk of endophthalmitis. Same day bilateral injections should be performed as two separate procedures, preferably using drug from different lots, especially when using compounded drugs.

show abstract

Correspondence

Cited by 2 publications

References 3 publications

Changing paradigms of anti-VEGF in the Indian scenario

Changing paradigms of anti-VEGF in the Indian scenario

Endophthalmitis following intravitreal anti-vascular endothelial growth factor (VEGF) injection: a comprehensive review

Contact Info

Product

Resources

About