[Intravitreous injection: retrospective study on 2028 injections and their side effects].
OBJECTIVE
To observe the tolerance of repeated intravitreous injections over the short and long term and to analyze their complications.


METHODS
The clinical records of consecutive patients having one or several intravitreous injections between 2002 and 2007 were evaluated, for all indications except the treatment of endophthalmitis.


RESULTS
2028 intravitreous injections were performed, mainly for age-related macular degeneration (n=1 192) or macular edema secondary to diabetes mellitus or retinal vein occlusion (n=41). The injected drug was triamcinolone acetonide 4 mg (339 injections), pegaptanib sodium 0.3 mg (1179 injections), and ranibizumab 0.3 (497 injections). The patients received 1-27 intravitreous injections per eye. The main complications were endophthalmitis (two after triamcinolone, 0.1% of the total group), pseudoendophthalmitis (two after triamcinolone, 0.1% of the total group), hypertony (7.69% of the total group, 13.78% after triamcinolone, 3.56% after pegaptanib, 1.21% after ranibizumab), including five cases of acute hypertony with transient light perception loss after ranibizumab, cataract (0.44% of total group), and macular hole (one patient after triamcinolone). No case of retinal detachment nor systemic complication was observed.


CONCLUSIONS
Most of the complications were observed with the use of nonfiltered triamcinolone. The incidence of endophtalmitis was considerably lower with increased experience and the use of a dedicated room for the injections. Repeated injections were locally well tolerated.


CONCLUSIONS
With the strict respect of asepsis rules, intravitreous injection seems well tolerated over the short and long term.
Angulo Bocco
M C
MC
Service d'Ophtalmologie, Hôpital Intercommunal, Créteil, France.
Glacet-Bernard
A
A
Zourdani
A
A
Coscas
G
G
Soubrane
G
G
D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002386:Cataract / Q000209:etiology*; D003930:Diabetic Retinopathy / Q000188:drug therapy; D009877:Endophthalmitis / Q000209:etiology*; D019773:Epiretinal Membrane / Q000188:drug therapy; D006801:Humans; D007267:Injections / Q000009:adverse effects* / Q000379:methods; D008268:Macular Degeneration / Q000188:drug therapy; D008269:Macular Edema / Q000188:drug therapy; D009798:Ocular Hypertension / Q000209:etiology*; D000069579:Ranibizumab; D012163:Retinal Detachment / Q000209:etiology*; D012167:Retinal Perforations / Q000209:etiology; D012170:Retinal Vein Occlusion / Q000188:drug therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D014822:Vitreous Body; D014823:Vitreous Hemorrhage / Q000209:etiology*
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide; C495058:pegaptanib; D014222:Triamcinolone Acetonide; D000069579:Ranibizumab