Search

Purpose: To describe a technique for extemporaneously drawing up bevacizumab for intravitreal injection (IVT) and report the rate of post-injection endophthtalmitis., Patients and Methods: Retrospective monocentric analysis (January 2010-December 2014) of all IVT of bevacizumab drawn up with the following technique: in the operating room (class ISO 7) through a mini-spike with an integrated bacteria retentive air filter. The surgeon was wearing sterile gloves and a mask. The assisting nurse wore a mask. The bevacizumab vial was discarded at the end of each session., Results: Six thousand two hundred and thirty-six bevacizumab injections were performed. One case of endophthalmitis was noted (0.016%). During the same period, 4 cases of endophthalmitis were found after IVT of other drugs (4/32,992; 0.012%. P=0.8)., Conclusion: Intravitreal injection of bevacizumab after extemporaneous withdrawal through a mini-spike filter is a simple and safe technique. The risk of postoperative endophthalmitis is very low. This simple technique facilitates access to compounded bevacizumab., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Intravitreal injections are very commonly performed in the daily practice of Ophthalmology and become a leading procedure in the management of age-related macular degeneration, diabetic retinopathy, infectious endophthalmitis or retinitis, uveitis and retinal vein occlusions. Based on the comments of a group of experts, including ophthalmologists, pharmacists and hygienists, the French Agency for the Safety of Health Products (AFSSAPS) edited a guide to good practice of intravitreal injections, revisiting those previously published in 2006. The overall experience accumulated during time is a valuable source of information to determine the most appropriate protocol. Therefore, the simplification of the procedure is reasonably proposed even though safety remains a major issue, in order to avoid complications, especially infections., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Purpose: To assess the efficacy of early injection of intravitreal triamcinolone acetonide (IVTA) versus delayed injection for macular edema from retinal vein occlusion., Methods: This was a retrospective monocentric study. Forty-four patients received an IVTA (4 mg) for macular edema resulting from central retinal vein or branch retinal vein occlusion. The patients were assigned to two groups: group 1 consisted of patients who received an IVTA less than 6 weeks after the diagnosis of macular edema, while group 2 consisted of patients who received the injection more than 6 weeks after. All patients underwent a comprehensive ophthalmological examination before the injection and 1, 3, and 6 months after. Each visit included best-corrected visual acuity measurement (BCVA), slit lamp examination, intraocular pressure measurement, fundus examination and central macular thickness (CMT) measurement by OCT., Results: The two groups were comparable in terms of age, sex-ratio, and the percentage of branch retinal vein occlusion (54 and 61% in groups 1 and 2, respectively). In group 1, the BCVA (logMAR) was 0.87 before the IVTA and significantly improved at 1 and 3 months (0.46 and 0.48, respectively; P<0.05) before worsening at the 6-month visit (0.62; P>0.05). The mean CMT was also significantly improved (from 567 μm before the injection to 276, 307, and 386 μm at the 1-, 3-, and 6-month visits, respectively) (P<0.05 at 1 and 3 months). In group 2, there were no significant differences in visual acuity at any time point (0.86 before the IVTA, 0.76, 0.76, and 0.78 at the 1-, 3-, and 6-month visits; P>0.05). The CMT was reduced after the injection from 552 μm to 294, 446, and 456 μm at the 1-, 3-, and 6-month visits, respectively (P<0.05 at 1 month)., Conclusion: Patients with macular edema due to retinal vein occlusions, who received a single intravitreal injection of triamcinolone acetate less than 6 months after the diagnosis, displayed both anatomical and functional improvement, whereas patients injected more than 6 weeks after the diagnosis of macular edema showed a CMT reduction but with less improvement in visual acuity. The difference observed at 1 month disappeared after 6 months., (Copyright © 2011. Published by Elsevier Masson SAS.)