Evaluation of the Safety of Bilateral Same-Day Intravitreal Injections of Anti-Vascular Endothelial Growth Factor Agents: Experience of a Large Korean Retina Center

Kyuhwan Jang,1 Jayoung Ahn,1 Joonhong Sohn,1 Daniel Duck-Jin Hwang1,2 1Department of Ophthalmology, HanGil Eye Hospital, Incheon, Korea; 2Department of Ophthalmology, Catholic Kwandong University College of Medicine, Incheon, KoreaCorrespondence: Daniel Duck-Jin HwangDepartment of Ophthalmology, HanGil Eye Hospital, #35 Bupyeong-Daero, Bupyeong-Gu, Incheon 21388, KoreaTel +82-32-503-3322Fax +82-32-504-3322Email daniel.dj.hwang@gmail.comPurpose: To evaluate the short-term ophthalmic side effects of bilateral same-day intravitreal anti-vascular endothelial growth factor (VEGF) injections.Patients and Methods: We retrospectively analyzed patients who received intravitreal bevacizumab, ranibizumab, and aflibercept injections in both eyes on the same day between January 2014 and June 2019. The patients were followed up for 1 day, 1 week, and 1 month after the injections.Results: A total of 323 patients (646 eyes) received 1418 bilateral same-day intravitreal anti-VEGF injections. The patients’ mean age was 62.47 ± 13.97 years. The most common cause of bilateral injection was age-related macular degeneration (54.80%), followed by complications due to diabetic retinopathy (35.33%), retinal vein occlusion (2.40%), and central serious chorioretinopathy (1.27%). There were 22 cases of subconjunctival hemorrhage, 17 cases of temporary elevation of intraocular pressure, and no case of endophthalmitis. Twenty-one patients showed acute intraocular inflammation after the bilateral injection. All patients showed complete improvement within 2 weeks after the injection.Conclusion: Bilateral same-day intravitreal anti-VEGF injection is a well-tolerated procedure on short-term follow-up. It is one of the more convenient approaches for both the patient and ophthalmologist.Keywords: anti-vascular endothelial growth factor, bilateral intravitreal injection, bevacizumab, aflibercept, ranibizumab, safety