Complications Related to Intravitreal Injections Encountered at a Tertiary Eye Care Center

Ocular complications following intravitreal injections are rare, according to a study presented by Michael S. Ramos, BA, from the Cole Eye Institute, Cleveland Clinic Foundation, at the 37^th Annual ASRS Meeting.

In this retrospective study, researchers reviewed the electronic health record (EHR) system of a tertiary eye care center searching for intravitreal injections which were followed by unscheduled ophthalmology appointments within 14 days of injection performed between 2012 and 2013. These encounters comprised telephone calls, office visits, and emergency room (ER) visits with any ophthalmologic complication. The researchers aggregated data based on complication type, number of days to encounter, and change in visual acuity (VA) at encounter and one-year post encounter.

The results of the study showed that 10,007 injections were performed in six cases (0.060%) of endophthalmitis: four of which were culture-positive and two culture-negative. At the time of encounter, vision was reduced from baseline by 11.7 lines for culture-positive and 17.5 lines for culture-negative (P=0.72). Furthermore, after one year, vision was reduced from baseline by 4.2 lines and 1.9 lines for the culture-positive and negative groups respectively (P=0.74). Mean days to presentation for culture-positive and negative groups were 3.8 and 4.0, respectively (P=0.93).

Moreover, 215 injections (2.15%) resulted in one or more unscheduled encounters (84 telephone, 131 office visits, and two emergency room) for a total of 220 complications. The results indicated that the most common complications were ocular irritation (n=83; 0.82 %), subconjunctival hemorrhage (n=73; 0.73%), and air bubble (n=14; 0.14%). Overall, the most common serious complications were increased intraocular pressure (n=10; 0.10%), iritis (n=6; 0.06%), and endophthalmitis (n=6; 0.06%).

“Ocular complications following intravitreal injections are uncommon,” the authors wrote in their conclusion. “Knowledge of complication rates and their presenting symptoms will help counsel patients prior to initiating intravitreal therapy.”

Ramos M. Complications Related to Intravitreal Injections Encountered at a Tertiary Eye Care Center. Presented at the 37^th ASRS Annual Meeting; July 26-30, 2019; Chicago, IL.

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