Incidence of endophthalmitis after intravitreal Anti-vascular endothelial growth factor: Experience in Saudi Arabia

Al-Rashaed, Saba; Alsulaiman, Sulaiman M.; Alrushood, Abdulaziz Adel; Almasaud, Jluwi; Arévalo, J. Fernando

doi:10.4103/0974-9233.171756

Cited by 14 publications

(5 citation statements)

References 22 publications

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“…e side and adverse effects are rare, but the high volume of performed on international scale makes the IVI complications a severe issue for the ophthalmologists [14]. e most dramatic complication is endophthalmitis that potentially can lead to complete functional impairment or even to evisceration [15]. According to Italian Ophthalmological Society (SOI), intravitreal injections should be provided by an ophthalmic surgeon and must be carried out in an operating theatre, in order to prevent infective risks [16].…”

Section: Discussionmentioning

confidence: 99%

Intravitreal Injections in Arc Sterile Setting: Safety Profile after More Than 10,000 Treatments

Furino

Grassi

Bini

et al. 2020

Journal of Ophthalmology

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Purpose. To report the occurrence of endophthalmitis and other complications after intravitreal injections (IVIs) in the Arc Sterile setting. Methods. A retrospective study that enrolled all patients who underwent IVIs between November 2017 and March 2019, collecting data about the patient’s gender and age, type of injected drug, diagnosis, other ocular pathologies, physician and possible occurrence of endophthalmitis, or other complications. Results. Ten thousand and eighty-three IVIs were performed during the study period, involving 2014 eyes of 1,670 patients with an average age of 71.37 ± 11.63 years. The injected drugs included ranibizumab (54.6%), aflibercept (38.0%), dexamethasone (6.7%), pegaptanib (0.3%), bevacizumab (0.4%), and ocriplasmin (0.01%). The diagnosis included neovascular age-related macular degeneration (859), myopic choroidal neovascularization (154), diabetic macular edema (576), retinal vein occlusion (203), and miscellaneus diagnosis (222). No cases of endophthalmitis were recorded. One hundred and sixty-nine cases of ocular hypertension were detected, while the most frequent complication was subconjunctival hemorrhage, identified after 1,180 IVIs. The residents performed over 80% of IVIs, but there was no statistically significant difference in incidence of complications between the residents group and consultants group. Conclusions. Arc Sterile seems to be a safe setting in which IVIs can be carried out, regarding infective risk, and it is easy to set up compared to operation theatre and useful to improve intravitreal injections governance.

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Section: Discussionmentioning

confidence: 99%

Intravitreal Injections in Arc Sterile Setting: Safety Profile after More Than 10,000 Treatments

Furino

Grassi

Bini

et al. 2020

Journal of Ophthalmology

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“…It can progress to complete visual loss. Treatment options available for it, once it gets developed, is the intravitreal injection of antibiotics, followed by vitrectomy or evisceration [12,17,18]. The presented case in our study was treated with intravitreal injections of vancomycin and ceftazidime followed by 3PPPV and his visual outcome improved significantly after this intervention.…”

Section: Discussionmentioning

confidence: 73%

Incidence of Acute Endophthalmitis After Intravitreal Bevacizumab Injection at a Tertiary Care Hospital in Lahore

Ahmed¹,

Rehman²,

Rafique³

et al. 2021

Cureus

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Objective: We aimed to assess the incidence, management, and visual outcome of acute endophthalmitis in patients following intravitreal bevacizumab injection in a tertiary care setup. It was a prospective and single-center database study. Patients and methods: Patients receiving intravitreal bevacizumab injections for various retinal vascular diseases from January 2019 to September 2020. The study was carried out at the Institute of Ophthalmology, Mayo Hospital, Lahore over a period of 21 months. Preformed bevacizumab injections were administered intravitreally on patients of various retinal vascular diseases under strict aseptic measures and by following the standard guidelines. The patients were put on follow-ups for a duration of four weeks to see any signs of acute endophthalmitis. Results: A total of 3051 injections were administered in 1104 eyes of 743 patients during the abovementioned study period. The incidence of endophthalmitis was found to be 0.0328% (1/3051). The patient, who developed endophthalmitis, was treated with topical and intravitreal antibiotics followed by vitrectomy that resulted in clinically significant improvement in vision. Conclusion: Incidence of acute endophthalmitis following intravitreal bevacizumab injection was low and could be prevented by taking strict aseptic measures during administration.

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“…Al-Rasheed et al previously described our institution's intravitreal injection protocol. 15 Our Aflibercept vial contains 4mg/0.1ml, and the recommended dosage per eye is 2 mg/0.05ml. The intravitreal injection is performed as an outpatient procedure, and the intraocular pressure (IOP) and vision are monitored immediately following the process.…”

Section: Methodsmentioning

confidence: 99%

The Impact of Aflibercept on Diabetic Macular Edema Patients Refractory to Ranibizumab in a Tertiary Care Eye Specialist Hospital, Saudi Arabia

AlHumaidan¹,

Alzuman²,

Mazhar³

et al. 2021

PTB Reports

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Aim:The purpose of this study is to see if switching from intravitreal Ranibizumab, an anti-Vascular Endothelial Growth Factor (anti-VEGF), to Aflibercept is evidence-based in the diabetic Saudi population. We compared the efficacy of three injections of the Aflibercept treatment regimen in diabetic macular edema (DME) cases refractory to Ranibizumab. Methods: In 2018, a retrospective single-arm cohort study was carried out. Cases of refractory DME were evaluated before and after three injections of Ranibizumab, as well as three Aflibercept treatment regimens. Optical Coherence Tomography (OCT) was used to investigate changes in Central Macular Thickness (CMT) (anatomic outcome). In addition, changes in the CMT and Best Corrected Visual Acuity (BCVA) (functional outcome) were assessed. Results: The cohort consisted of 74 eyes from 74 DME patients. As an anatomical indicator, the mean CMT decreased from 482±153 µ to 385.6±134.6 µ after three injections of Ranibizumab. In contrast, with Aflibercept treatment, the mean CMT decreased to 370.2±116.9 µ. The decrease in CMT was statistically significant [94.6µ (95% confidence interval (CI): 54.8; 134.3] (P 0.001). In addition, BCVA improved by two or more lines in 17 (23%) of the eyes treated with Aflibercept, remained unchanged in 40 (54%) of the eyes, and decreased in 17 (23%) of the eyes. Conclusion: The anatomic successes of both anti-VEGF (Ranibizumab and Aflibercept) treatment regimens in Saudi patients with DME are promising. The Aflibercept treatment regimen improves success in refractory DME cases, but the visual improvement appears to be limited.

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Incidence of endophthalmitis after intravitreal Anti-vascular endothelial growth factor: Experience in Saudi Arabia

Cited by 14 publications

References 22 publications

Intravitreal Injections in Arc Sterile Setting: Safety Profile after More Than 10,000 Treatments

Intravitreal Injections in Arc Sterile Setting: Safety Profile after More Than 10,000 Treatments

Incidence of Acute Endophthalmitis After Intravitreal Bevacizumab Injection at a Tertiary Care Hospital in Lahore

The Impact of Aflibercept on Diabetic Macular Edema Patients Refractory to Ranibizumab in a Tertiary Care Eye Specialist Hospital, Saudi Arabia

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