Injection intravitréenne : évaluation rétrospective de la technique et des complications d’une série de 2028 injections

Bocco, M.C. Angulo; Glacet–Bernard, A.; Zourdani, A.; Coscas, G.; Soubrane, G.

doi:10.1016/s0181-5512(08)74383-3

Cited by 24 publications

(6 citation statements)

References 25 publications

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“…However, intravitreal injection can result in complications, including endophthalmitis, intraocular hemorrhage, and ocular hypertension. Several studies have addressed these complications [ 4 5 6 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Longitudinal Changes in Retinal Nerve Fiber Layer Thickness after Intravitreal Anti-vascular Endothelial Growth Factor Therapy

Kim

Shin

et al. 2016

Korean J Ophthalmol

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PurposeTo determine the effects of intravitreal anti-vascular endothelial growth factor (VEGF) on thickness of the retinal nerve fiber layer (RNFL) in patients with age-related macular degeneration.MethodsTwenty eyes of 20 patients diagnosed with age-related macular degeneration who underwent intravitreal anti-VEGF injection were studied. Postinjection RNFL thickness was measured using optical coherence tomography. Average thickness, four-quadrant RNFL thicknesses, and intraocular pressure (IOP) in affected eyes were measured before and 6 and 12 months after anti-VEGF injection for comparison. RNFL thickness and IOP in affected and normal fellow eyes were also compared. Given that macular lesions can affect RNFL thickness, the changes in thickness were evaluated by dividing the 12 clock-hour RNFL into the pathologic areas adjacent to the lesion and the non-pathologic area.ResultsThe mean clock-hour segment in the pathologic area was 4.8 hours. A significantly thicker RNFL was exhibited in temporal quadrants and pathologic areas (p = 0.043 and 0.048, respectively) in affected eyes before injection compared to the baseline RNFL thickness in normal eyes. No significant differences were found in RNFL thickness or IOP between affected and normal eyes after injection. The changes over time in the temporal and pathologic areas were statistically significant at 6 and 12 months after injection compared to baseline data (p < 0.05). No significant differences were displayed in RNFL thickness in the other three quadrants or in non-pathologic areas in either affected or normal eyes. Sequential changes in RNFL thickness in affected eyes were not significant.ConclusionsRepeat intravitreal anti-VEGF treatment did not have a significant effect on RNFL thickness. RNFL thickness significantly decreased with time in the pathologic areas and in the temporal segment adjacent to exudative macular lesions. The reduction in RNFL thickness was most likely associated with changes in the macular lesion rather than with anti-VEGF injection.

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Section: Discussionmentioning

confidence: 99%

“…The efficacies of the anti-VEGF agents ranibizumab (Lucentis; Genentech, San Francisco, CA, USA) and bevacizumab (Avastin, Genentech) have been illustrated in many studies, although some complications have been reported [ 4 5 6 7 ]. Elevated intraocular pressure is a common complication following intravitreal injection of anti-VEGF.…”

mentioning

confidence: 99%

Longitudinal Changes in Retinal Nerve Fiber Layer Thickness after Intravitreal Anti-vascular Endothelial Growth Factor Therapy

Kim

Shin

et al. 2016

Korean J Ophthalmol

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“…Determination of the dosage of triamcinolone and bevacizumab had been based on the dose and volume of drug used for intravitreal administration of bevacizumab or triamcinolone in other studies [7,10,11,12] and previous investigations of the administration of drugs to the suprachoroidal space [9]. The operational steps included priming the microcatheter with the bevacizumab injectate prior to insertion into the suprachoroidal space.…”

Section: Methodsmentioning

confidence: 99%

“…Despite the tremendous strides made in the treatment of CNV associated with a variety of chorioretinal disorders, some patients remain unresponsive to widely applied therapies including intravitreal injections of vascular endothelial growth factor antagonists [2,3]. Limitations of intravitreal injections include the need for multiple injections [4] and the risk of complications such as endophthalmitis [5], retinal detachment [6] and cataract formation [7]. In addition, drug treatment of posterior segment diseases of the eye such as CNV may be hampered by poor intraocular penetration and rapid elimination of the drug from the eye [8].…”

Section: Introductionmentioning

confidence: 99%

Safety of Submacular Suprachoroidal Drug Administration via a Microcatheter: Retrospective Analysis of European Treatment Results

2012

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Purpose: To investigate the safety and feasibility of using a microcatheter for drug delivery in the suprachoroidal space in eyes with advanced, exudative, age-related macular degeneration (AMD) unresponsive to conventional therapy. Procedures: A unique microcatheter was used to deliver a drug combination consisting of bevacizumab and triamcinolone to the submacular suprachoroidal space. Twenty-one eyes of 21 patients with choroidal neovascularization (CNV) secondary to advanced, exudative AMD were followed over a 6-month postprocedure period. Results: The microcatheter was successfully and atraumatically inserted into the suprachoroidal space of all eyes. No serious intraoperative or postoperative complications including suprachoroidal hemorrhages were encountered. Postsurgically, complications consisted of 1 eye experiencing a transient elevation in intraocular pressure at 3 months, which was medically controlled, and 2 eyes (10.5%) with an apparent increase in nuclear sclerotic cataracts. Conclusions: Suprachoroidal drug administration was achieved without serious complication using a novel microcatheter. Direct drug delivery to the choroid can potentially increase local tissue drug levels and drug efficacy for the treatment of AMD and other diseases associated with CNV.

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“…Complications that can occur during the ranibizumab administration are rare, and they are locally related only to complications which can happen in all intravitreally administered medicaments, such as suffusion, anterior uveitis, briefly increased intra ocular pressure, cataract, and less frequently retinal detachment, haemophthalmos, and very rarely endophthfalmitis. System complications are very serious, but fortunately rare (21). Described have been cardiovascular complications, acute myocardial infarction with a possibility of lethal outcome, cerebrovascular accidents ranging from mild transient ischemic attack to serious cerebrovascular insult (22, 23).…”

Section: Therapeutic Options For Dry Amdmentioning

confidence: 99%

Therapeutic Modalities of Exudative Age-related Macular Degeneration

Mavija¹,

Alimanovic²,

Jaksic³

et al. 2014

Med Arh

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Introduction:Age-related macular degeneration (AMD) is a leading cause of irreversible serious vision damage in persons over 50 years of age. In treating AMD many medicaments are applied such as inhibitors of vascular endothelial growth factor (VEGF), have been very carefully included over the last few years after a series of study research.Aims:To analyze the past methods of treatment, discuss emerging therapies which could advance the treatment of exudative AMD. The past anti-VEGF therapies require frequent repetitions of administration, with uncertain visual acuity recovery, as not all patients react to anti-VEGF therapy. Consequently, there is a need to find out additional therapies which could improve the treatment of exudative AMD. The real aim in the treating of AMD is to prevent CNV development.Methods:A survey of the current clinical research and results in the field of the present and future treatments of exudative AMD.Results:There are many areas of research into new methods of the exudative AMD treatment.Conclusion:The future therapies for exudative AMD treatment have a potential not only to reduce the frequency of administration and follow-up visits, but also to improve effects of treatment by targeting additional ways of CNV development, increasing the aptitude of target binding and extending durability of treatment.

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Injection intravitréenne : évaluation rétrospective de la technique et des complications d’une série de 2028 injections

Cited by 24 publications

References 25 publications

Longitudinal Changes in Retinal Nerve Fiber Layer Thickness after Intravitreal Anti-vascular Endothelial Growth Factor Therapy

Longitudinal Changes in Retinal Nerve Fiber Layer Thickness after Intravitreal Anti-vascular Endothelial Growth Factor Therapy

Safety of Submacular Suprachoroidal Drug Administration via a Microcatheter: Retrospective Analysis of European Treatment Results

Therapeutic Modalities of Exudative Age-related Macular Degeneration

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