Survey of intravitreal injection techniques and treatment protocols among retina specialists in Canada

Lin, Xichuan; Dorrepaal, Stephen J.; Gale, Jeffrey

doi:10.1016/j.jcjo.2014.03.009

Cited by 46 publications

(63 citation statements)

References 43 publications

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“…The results of our study were similar to those of their study with respect to the use of eyelid speculum, povidone–iodine before the IVT injection, and topical antibiotics after the IVT injection. A Canadian survey was conducted among retina specialists in 2012 (n=75) 7. Like our study, a majority of ophthalmologists in the Canadian survey used eyelid speculums.…”

Section: Discussionmentioning

confidence: 95%

Practice patterns of ophthalmologists administering intravitreal injections in Europe: a longitudinal survey

Huang¹,

Sultan²,

Zhou³

et al. 2016

OPTH

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PurposeThis study was performed to understand the practice patterns of ophthalmologists administering intravitreal (IVT) injections in Europe after the procedure became routine.MethodsAs part of a prospective, multinational, non-interventional cohort study in 13 countries in Europe between 2006 and 2012, ophthalmologists completed the Baseline Questionnaire and the Follow-up Questionnaire 1 year after baseline.Results and discussionOf the 125 ophthalmologists who participated in the study, 113 (90.4%) completed the Baseline Questionnaire. Most of these ophthalmologists were medical retina specialists (43.0%). The median number of IVT injections that the ophthalmologists performed per month during the year prior to completing the Baseline Questionnaire was 20.0. The majority of the ophthalmologists had performed their last IVT injection prior to completing the questionnaire in an operating room or theater (68.4%). When performing IVT injections, a majority of the ophthalmologists reported applying povidone–iodine (90.4%) before IVT injections and topical antibiotics right after IVT injections (89.5%). In addition, 81.6% of the ophthalmologists reported using a sterile adhesive eye drape and 80.7% reported using an eyelid speculum. In all, 95 ophthalmologists (76%) completed the Follow-up Questionnaire. The median number of IVT injections performed per month during the year prior to completing the Follow-up Questionnaire by these ophthalmologists was increased to 35. The results of the Follow-up Questionnaire on administering IVT injections were similar to those of the Baseline Questionnaire. A majority of the ophthalmologists reported applying povidone–iodine (87.4%) before IVT injections, topical antibiotics right after IVT injections (89.5%), and an eyelid speculum (85.3%).ConclusionThe results of this study indicated a good adherence to all aspects of the guidelines on IVT injections. It seemed that ophthalmologists were more experienced in IVT injections after they became a routine treatment procedure.

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Section: Discussionmentioning

confidence: 95%

Practice patterns of ophthalmologists administering intravitreal injections in Europe: a longitudinal survey

Huang¹,

Sultan²,

Zhou³

et al. 2016

OPTH

View full text Add to dashboard Cite

show abstract

“…In the USA and Canada, IVI are mainly performed in the office [65, 66], whereas in other countries IVI are limited to the operation room or a sterile room with identical hygienic standards in order to decrease infection, especially EO.…”

Section: Peri- /Injection Management In Intravitreal Pharmacotherapymentioning

confidence: 99%

“…In everyday routine, pre-IVI anesthesia protocols vary widely, with proparacaine or lidocaine drops (90%) being most frequently used in Canada for example, followed by topical lidocaine gel, topical pledget, and subconjunctival lidocaine injections [65]. …”

Section: Peri- /Injection Management In Intravitreal Pharmacotherapymentioning

confidence: 99%

“…A survey among Canadian ophthalmologists showed that most doctors dilate the pupil before IVI (83%) [65]. In the UK 78% of treating physicians dilated before the administration of intravitreal triamcinolone.…”

Section: Peri- /Injection Management In Intravitreal Pharmacotherapymentioning

confidence: 99%

“…A Canadian survey revealed that 71% of health care providers therefore use sterile masks for IVI [65]. …”

Section: Peri- /Injection Management In Intravitreal Pharmacotherapymentioning

confidence: 99%

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2018 Update on Intravitreal Injections: Euretina Expert Consensus Recommendations

et al. 2018

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Intravitreal injections (IVI) have become the most common intraocular procedure worldwide with increasing numbers every year. The article presents the most up-to-date review on IVI epidemiology and techniques. Unfortunately, important issues related to pre-, peri- and postinjection management lack randomized clinical trials for a final conclusion. Also, a great diversity of approaches exists worldwide. Therefore, expert consensus recommendations on IVI techniques are provided.

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Safety of Receiving Anti–Vascular Endothelial Growth Factor Intravitreal Injection in Office-Based vs Operating Room Settings

Sun

Min

et al. 2021

JAMA Ophthalmol

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IMPORTANCECompared with the operating room (OR), office-based intravitreal injection (IVI) is considered a more cost-effective and convenient approach, yet clinical outcomes of IVIs with anti-vascular endothelial growth factor (VEGF) agents in different settings (office-based vs OR) have not been systematically evaluated.OBJECTIVE To evaluate the safety outcomes of IVI with anti-VEGF agents in the OR vs office-based setting.DATA SOURCES PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov were searched from inception to July 2020.STUDY SELECTION Eligible studies reporting on patients who received IVIs with anti-VEGF drugs with a clearly stated injection setting of the office or OR.DATA EXTRACTION AND SYNTHESIS Two reviewers independently screened studies, extracted data, and assessed risk of bias. A meta-analysis was conducted to determine the rates of endophthalmitis (EO) and culture-positive EO. MAIN OUTCOMES AND MEASURESRates of EO and culture-positive EO following anti-VEGF IVIs in the OR and office-based setting.RESULTS Thirty-one studies with a total of 1 275 815 injections were included. Comparative analysis suggested no difference between rates of EO after IVIs performed in the office and OR settings (odds ratio, 3.06; 95% CI, 0.07-139.75; P = .57; I 2 = 80%) were identified, yet a higher rate of culture-positive EO was found in the office setting (odds ratio, 21.52; 95% CI,; P = .006; I 2 = 0%). The pooled rates of EO following anti-VEGF IVIs were 0.03% (95% CI, 0.03-0.04) and 0.02% (95% CI, 0.01-0.04) in office and OR settings, respectively, and the pooled rates of culture-positive EO were 0.01% (95% CI, 0.01-0.02) and 0.01% (95% CI, 0-0.02). The pooled rates of other ocular and systemic adverse events were low. CONCLUSIONS AND RELEVANCEThe rate of clinically suspected or culture-positive EO following anti-VEGF IVIs was low whether the procedure was performed in the office or OR setting. Bacterial spectrum could differ between the 2 settings. This meta-analysis could not determine if it is more appropriate to give treatment in the OR for safety reasons in low-income compared with higher-income regions in the world.

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Survey of intravitreal injection techniques and treatment protocols among retina specialists in Canada

Cited by 46 publications

References 43 publications

Practice patterns of ophthalmologists administering intravitreal injections in Europe: a longitudinal survey

Practice patterns of ophthalmologists administering intravitreal injections in Europe: a longitudinal survey

2018 Update on Intravitreal Injections: Euretina Expert Consensus Recommendations

Safety of Receiving Anti–Vascular Endothelial Growth Factor Intravitreal Injection in Office-Based vs Operating Room Settings

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