Administration of repeat intravitreal anti-VEGF drugs by retina specialists in an injection-only clinic for patients with exudative AMD: patient acceptance and safety.

摘要

PURPOSE: To report patient acceptance and safety of repeated intravitreal injections of anti-VEGF agents for exudative AMD, by retina specialists, without an eye examination before every injection. METHODS: Retrospective chart review. 115 eyes (110 patients) with exudative AMD underwent repeated intravitreal anti-VEGF injections with limited interval examination and diagnostic testing. Medication, laterality, number of injection cycles started and completed, number of injections per injection cycle, subjective visual changes, pre- and post-injection visual acuity (VA), pre- and post-injection intraocular pressure (IOP), nurse- and patient-initiated phone calls, emergency (non-scheduled) clinic visits, complications, new diagnoses, and patient complaints after each injection were recorded. The main outcome measures were complications and patient complaints. RESULTS: 396 injections were administered in the injection clinic to 110 patients in 175 injection cycles (range: 0 to 5 injections per cycle). Of 175 injection cycles, there were 134 uninterrupted cycles and 41 interrupted cycles where an eye exam was performed. Fourteen new diagnoses were made: six during emergency visits, three at injection clinic appointments, and five at the next full examination after completion of a prescribed injection clinic cycle. CONCLUSIONS: Administration of anti-VEGF injections in a designated injection clinic, by retina specialists, according to a prescribed schedule, and with limited pre-injection testing, for patients with wet AMD, is well-tolerated.