Intravitreal injection associated rhegmatogenous retinal detachment: outcomes of a European analysis

Abstract

Purpose As the number of intravitreal injections (IVI) increases annually, this study aimed to assess the anatomical and functional outcomes following rhegmatogenous retinal detachment (RRD) surgery for IVI-associated RRD (IVARD). Methods All non-vitrectomized eyes developing IVARD since 2007 in two European vitreoretinal centers (Department of Ophthalmology, LMU Munich, Germany, and Eye Clinic Luigi Sacco, University of Milan, Milan, Italy) were included. Main outcomes were primary and secondary retinal attachment rate after surgery, rate of proliferative vitreoretinopathy (PVR), and final functional result. Ten years of incidence rates per injection were calculated for one center. Results Fifty-two eyes of 52 patients comprised the study. Primary anatomic success rate was 83% (n = 43) and secondary 96% (n = 50). PVR was observed in all uveitic eyes (n = 3), in eyes with postoperative cystoid macular edema (n = 2), and in 8 of 9 eyes that received the dexamethasone implant (DEX). Age, number of prior injections, duration of symptoms, or time between last IVI and RRD did not show any statistically significant differences with regard to presence of PVR or not. Mean BCVA improved in 28 cases, remained stable in 16 cases, and worsened in 8 cases. The RRD incidence rate was statistically significant higher for DEX and ocriplasmin compared with that for anti-VEGF agents. Conclusion The anatomical result after one surgical intervention seems acceptable, but the final visual outcome remains rather poor, because of the underlying macular disease. In our population, injection with DEX is associated with higher IVARD rate, presence and development of PVR, and recurrent RRD in comparison with anti-VEGF agents.

Werden Netzhautablösungen häufiger? Daten von 2 Universitätsaugenkliniken und Literaturübersicht

“…An evaluation of data from the "Fight Retinal Blindness!" register, comprising 13,792 patients and a total of 265,781 intravitreal injections within a period of 14 years, confirmed previous studies, showing that the rate of rhegmatogenous retinal detachments after VEGF inhibitor IVT treatment was very low and is unlikely to have a measurable effect on the overall incidence of retinal detachment [34,35].…”

“…Als eine der Komplikationen der IVOM wird eine Netzhautablösung beschrieben. Eine Auswertung aus dem Register „Fight Retinal Blindness!“ mit 13 792 Patienten und insgesamt 265 781 intravitrealen Eingaben innerhalb 14 Jahren bestätigte vorhergehende Studien und zeigte, dass die Rate von rhegmatogenen Netzhautablösungen nach VEGF-Inhibitor-IVT-Therapie sehr niedrig war und keinen messbaren Effekt auf die Gesamtinzidenz der Ablationes haben dürfte 34 , 35 .…”