Evaluation of pain during intravitreal Ozurdex injections vs intravitreal bevacizumab injections

Moisseiev, Elad; Regenbogen, Michael; Rabinovitch, Tamar; Barak, Adiel; Loewenstein, Anat; Goldstein, Michaella

doi:10.1038/eye.2014.129

Cited by 30 publications

(30 citation statements)

References 37 publications

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“…Knecht et al 17 reported that tunnelled injections were not associated with increased pain compared to straight injections. Moisseiev et al 18 found no significant difference between intravitreal injections of dexamethasone implant and bevacizumab in terms of pain. In our study, we also found no significant difference between intravitreal injections of dexamethasone implant, ranibizumab, and aflibercept in terms of pain.…”

Section: Discussionmentioning

confidence: 97%

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Comparison of pain during intravitreal dexamethasone, ranibizumab and aflibercept injection

Ertan

Duman

2020

Clinical and Experimental Optometry

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Background This study aimed to compare pain scores of patients during intravitreal aflibercept, ranibizumab or dexamethasone implant injection procedures. Methods This study included 162 eyes of 162 patients, who received intravitreal ranibizumab, aflibercept or dexamethasone implant injections at our clinic. Following the injection, patients were asked to rate their pain from 0 (no pain) to 10 (worst pain) using a visual analogue pain score survey (VAS). VAS was evaluated according to age, sex, indication for the injection, number of previous intravitreal injections, and lens status in the study eye. Results The mean VAS in the ranibizumab, aflibercept or dexamethasone implant groups was 3.38 ± 2.31, 3.82 ± 2.46, and 3.61 ± 2.94, respectively. Female patients reported a higher average pain score than male patients (p = 0.02). Also, phakic patients reported a higher average pain score than pseudophakic patients (p = 0.01). Pain did not significantly correlate with indication for the injection, number of injections, and injection drugs (p > 0.05). Conclusion Pain associated with intravitreal injection is generally mild and associated with sex, age, and lens status. There was no significant difference in pain between intravitreal injections of dexamethasone implant, ranibizumab or aflibercept.

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Section: Discussionmentioning

confidence: 97%

“…Moisseiev et al 18 reported there was no difference between eyes injected for the first time and eyes that were previously injected and lens status in terms of intensity of pain. Our study also showed that firsttime injections were not associated with more pain than eyes that underwent previous injections.…”

Section: Discussionmentioning

confidence: 99%

Comparison of pain during intravitreal dexamethasone, ranibizumab and aflibercept injection

Ertan

Duman

2020

Clinical and Experimental Optometry

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“…Despite the relatively large diameter of the injector needle, the level of pain associated with the insertion procedure is not appreciably different from that produced by intravitreal anti-VEGF treatment, as administered with a 28- to 30-gauge needle. 55 Since the implant is biodegradable, subsequent implant(s) can be inserted without the need for surgical removal of the existing implant.…”

Section: Dexamethasone Intravitreal Drug Delivery Systemmentioning

confidence: 99%

Dexamethasone intravitreal implant in the treatment of diabetic macular edema

Dugel¹,

Bandello²,

Loewenstein³

2015

OPTH

115

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Diabetic macular edema (DME) resembles a chronic, low-grade inflammatory reaction, and is characterized by blood–retinal barrier (BRB) breakdown and retinal capillary leakage. Corticosteroids are of therapeutic benefit because of their anti-inflammatory, antiangiogenic, and BRB-stabilizing properties. Delivery modes include periocular and intravitreal (via pars plana) injection. To offset the short intravitreal half-life of corticosteroid solutions (~3 hours) and the need for frequent intravitreal injections, sustained-release intravitreal corticosteroid implants have been developed. Dexamethasone intravitreal implant provides retinal drug delivery for ≤6 months and recently has been approved for use in the treatment of DME. Pooled findings (n=1,048) from two large-scale, randomized Phase III trials indicated that dexamethasone intravitreal implant (0.35 mg and 0.7 mg) administered at ≥6-month intervals produced sustained improvements in best-corrected visual acuity (BCVA) and macular edema. Significantly more patients showed a ≥15-letter gain in BCVA at 3 years with dexamethasone intravitreal implant 0.35 mg and 0.7 mg than with sham injection (18.4% and 22.2% vs 12.0%). Anatomical assessments showed rapid and sustained reductions in macular edema and slowing of retinopathy progression. Phase II study findings suggest that dexamethasone intravitreal implant is effective in focal, cystoid, and diffuse DME, in vitrectomized eyes, and in combination with laser therapy. Ocular complications of dexamethasone intravitreal implant in Phase III trials included cataract-related events (66.0% in phakic patients), intraocular pressure elevation ≥25 mmHg (29.7%), conjunctival hemorrhage (23.5%), vitreous hemorrhage (10.0%), macular fibrosis (8.3%), conjunctival hyperemia (7.2%), eye pain (6.1%), vitreous detachment (5.8%), and dry eye (5.8%); injection-related complications (eg, retinal tear/detachment, vitreous loss, endophthalmitis) were infrequent (<2%). Dexamethasone intravitreal implant offers a viable treatment option for DME, especially in cases that are persistent or treatment (anti-vascular endothelial growth factor/laser) refractory.

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“…Despite the larger gauge and use of a tunneled incision, dexamethasone implant injection was not found to be more painful than anti-VEGF injection [94].…”

Section: Dexamethasonementioning

confidence: 99%

Corticosteroids for the Treatment of Diabetic Macular Edema

Sharma

Mruthyunjaya

2014

Curr Ophthalmol Rep

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Diabetic macular edema (DME) is a leading cause of vision loss throughout the world. Three different corticosteroids have been used in the treatment of diabetic macular edema: triamcinolone acetonide, dexamethasone, and fluocinolone acetonide. Intravitreal injection of all three corticosteroids is associated with a similar side effect profile including worsening/formation of cataract, elevation of intraocular pressure, pseudo-endophthalmitis, and infectious endophthalmitis. Sustained-release implants of corticosteroids have recently been studied, and one has recently received FDA approval as the first corticosteroid for the treatment of diabetic macular edema. This review will address some of the major studies evaluating corticosteroids for DME and will focus on studies published within the last 2 years.

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Evaluation of pain during intravitreal Ozurdex injections vs intravitreal bevacizumab injections

Cited by 30 publications

References 37 publications

Comparison of pain during intravitreal dexamethasone, ranibizumab and aflibercept injection

Comparison of pain during intravitreal dexamethasone, ranibizumab and aflibercept injection

Dexamethasone intravitreal implant in the treatment of diabetic macular edema

Corticosteroids for the Treatment of Diabetic Macular Edema

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