Incidence of rhegmatogenous retinal detachments after intravitreal antivascular endothelial factor injections

Abstract

ABSTRACT.Purpose: To determine the incidence of rhegmatogenous retinal detachments (RD) after intravitreal injection in six high-volume centres. Methods: A consecutive, interventional, multicenter case series measured the incidence of RD in patients receiving intravitreal anti-VEGF. A total of 35 942 intravitreal anti-VEGF injections (the number of the injections determined by review of injection log books over a 3 year period) were performed under sterile conditions with the patient in a supine position. Injections were given 3.5-4.0 mm behind the limbus in a tunnelled fashion. Results: During 36 consecutive months, five RD were reported, between 2 and 6 days after the injection. Of the affected eyes, four were myopic )1.75 to )5.5 dpt. The incidence rate of rhegmatogenous RD was 0.013% (5 ⁄ 35 942) per injection. Conclusions: The incidence of RD in our community setting was very low (1 per 7188 injections). All RD occurred during the early postoperative period. The risks of RD can be minimized by a careful injection technique.

Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature

“…26,27 Rhegmatogenous retinal detachment The overall incidence of rhegmatogenous retinal detachment (RRD) after intravitreal injection of anti-VEGF agents is low (0 to 0.67%). 25,29 In a study on Medicare database, the differences in rates of RRD and retinal tear were not statistically significant between eyes with intravitreal anti-VEGF injection and a matched control group. 25 The etiology of RRD after intravitreal injection have been proposed to be an induction of posterior vitreous detachment or an incorrect technique of injection.…”

“…25 The etiology of RRD after intravitreal injection have been proposed to be an induction of posterior vitreous detachment or an incorrect technique of injection. 29 Paying attention to the surgical technique has been advocated to decrease the rate of RRD. This includes the precise site of injection (3.5-4 mm posterior to the limbus), using smaller gauge needles, and tunnelled insertion of the needle for avoiding vitreous wick and reflux.…”

“…This includes the precise site of injection (3.5-4 mm posterior to the limbus), using smaller gauge needles, and tunnelled insertion of the needle for avoiding vitreous wick and reflux. 29 Intraocular pressure elevation Acute rise of intraocular pressure (IOP) after intravitreal injection is injectionprocedure-related and lasts a few hours at most. 30,31 Recent studies, however, have reported a significant number of intravitreal anti-VEGF injections is associated with an increased risk for IOP elevation.…”

Ocular Safety of Intravitreal Injections of Age-Related Macular Degeneration Treatments in a Prospective Observational Cohort Study in Europe

“…The incidence of IVT injection-related traumatic cataract in AMD populations was 0% (the range of IVT injections in these studies was 345 to 1,114) [12,13]. Further review of the literature reveals that the incidence of the IVT injection-related retinal detachment in a mixed disease population was 0 to 0.019% per injection and the range of IVT injections in these studies was from 1,584 to 35, 942 [7,14], vitreous hemorrhage was 0% per injection (the number of IVT injections in this study was 3,938) [23]. The incidence of IVT injection-related hypersensitivity reactions is unknown.…”

Retinal Detachment - An Update of the Disease and Its Epidemiology - A Discussion Based on Research and Clinical Experience at the Prince Charles Eye Unit, Windsor, England

“…The Scottish Retinal Detachment Study Group, based on 12 months prospective research between 1 November 2007 and 31 October 2008, assessed 572 patients diagnosed with primary retinal detachment 29 . They came to the conclusion that retinal detachment is twice as common among the more affluent than those living in areas of deprivation.…”