title: [Complications of intravitreal injections--own experience].
abstract: OBJECTIVE
  Authors present complications associated with intravitreal injection perfomed in Ophthalmic Clinic CMKP MATERIAL AND METHODS: retrospective study, between January 2006 and July 2009 we performed intravitreal injections with triamcinolone acetonide (Kenalog, 4 mg), ranibizumab (Lucentis, 0.5 mg), bevacizumab (Avastin, 1.25 mg) and pegaptanib (Macugen, 0.3 mg). We treated eyes with age-related macular degeneration, diabetic macular edema, after retinal venous occlusion, with uveitis, Irvine-Gass syndrome, idiopathic juxtafoveolar teleangiectasia and central serous retinopathy.
  
  
  RESULTS
  943 eyes received intravitreal injections. The most common ocular complication was subconjunctival hemorrhage which was seen in 36% cases. Temporary elevated intraocular pressure above 21 mmHg was noticed in 18 eyes (5%) after anti-VEGF agents injections and in 30 eyes (23.4%) after Kenalog injection. Anterior uveitis developed in sixteen cases (1.7%) from the Avastin (5 eyes) and Lucentis (3 eyes) group. Anterior-posterior inflammation occurred in 8 eyes (0.8%), including four eyes (0.4%) with sterile endophthalmitis (3 following bevacizumab and 1 following ranibizumab injection), one eye (0.1%) with pseudoendophthalmitis (after triamcinolone). There were three cases of suspected endophthalmitis (2 following bevacizumab and 1 following triamcinolone injection). The infectious endophthalmitis after triamcinolone injection was culture-proven and revealed Staphylococcus epidermidis. Cataract formation or progression was noted in 34 eyes totally. In Kenalog group progression of cataract was seen in 23.4% of eyes (30 cases) during 2-years of follow-up and in anti-VEGF agents group--in two cases (0.6%) and 2 cases of iatrogenic cataract. Three diabetic patients suffered systemic adverse events: one patient developed renal insufficiency, one patient developed cerebrovascular accidents and one suffered a myocardial infarction resulting in death.
  
  
  CONCLUSIONS
  Intravitreal injections are associated with a low incidence of serious adverse events. The most common ocular complication was subconjunctival hemorrhage. There was one case of serious complication--the culture-proven infectious endophthalmitis after Kenalog injection. Cataract formation and increase of intraocular pressure were more often observed following intravitreal triamcinolone injection.
authors.affiliation: Z Oddziału Klinicznego Okulistyki Centrum Medycznego Kształcenia Podyplomowego w Warszawie. ajamrozy@poczta.fm
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Jamrozy-Witkowska
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kowalska
authors.forename: Irmina
authors.initials: I
authors.lastname: Jankowska-Lech
authors.forename: Barbara
authors.initials: B
authors.lastname: Terelak-Borys
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Nowosielska
authors.forename: Iwona
authors.initials: I
authors.lastname: Grabska-Liberek
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide / Q000008:administration & dosage; D000068258:Bevacizumab; D003229:Conjunctival Diseases / Q000139:chemically induced; D003930:Diabetic Retinopathy / Q000188:drug therapy; D009877:Endophthalmitis / Q000139:chemically induced; D005128:Eye Diseases / Q000139:chemically induced*; D005130:Eye Hemorrhage / Q000139:chemically induced; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007249:Inflammation / Q000139:chemically induced; D058449:Intravitreal Injections / Q000009:adverse effects*; D007499:Iris Diseases / Q000188:drug therapy; D008268:Macular Degeneration / Q000188:drug therapy; D008269:Macular Edema / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000139:chemically induced; D011044:Poland; D000069579:Ranibizumab; D012164:Retinal Diseases / Q000188:drug therapy*; D012170:Retinal Vein Occlusion / Q000188:drug therapy; D012189:Retrospective Studies; D012307:Risk Factors; D014222:Triamcinolone Acetonide / Q000008:administration & dosage; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide; D005938:Glucocorticoids; C495058:pegaptanib; D000068258:Bevacizumab; D014222:Triamcinolone Acetonide; D000069579:Ranibizumab