Analysis of urgent follow up visits and complications after intravitreal injections: a retrospective cohort study
Abstract Background Intravitreal injections (IVIs), a common treatment in ophthalmology, result in acute complications and urgent follow-up visits causing significant burden to both patient and physician. We evaluated the incidence of acute complications following IVIs which occurred within seven da...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-01-01
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| Series: | International Journal of Retina and Vitreous |
| Online Access: | https://doi.org/10.1186/s40942-021-00358-w |
| _version_ | 1819260929831862272 |
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| author | Alexander Miller Matthew A. Wilneff Andrew Yazji Emily Petrinec Michael Carbone Chase Miller Christina McCrossin Richard Donkor David G. Miller |
| author_facet | Alexander Miller Matthew A. Wilneff Andrew Yazji Emily Petrinec Michael Carbone Chase Miller Christina McCrossin Richard Donkor David G. Miller |
| author_sort | Alexander Miller |
| collection | DOAJ |
| description | Abstract Background Intravitreal injections (IVIs), a common treatment in ophthalmology, result in acute complications and urgent follow-up visits causing significant burden to both patient and physician. We evaluated the incidence of acute complications following IVIs which occurred within seven days of injection. Methods A retrospective cohort study conducted at a private retinal practice, in Cleveland, Ohio. Using the practice management software database, we examined 73,286 injections of patients with unscheduled or urgent visits within 7 days of an injection from August 1st,2018 to August 1st,2020. Data collected included: age, gender, eye, medication injected, diagnosis, reason for urgent follow-up, time between injection and urgent follow-up, and type of anesthesia administered. Data was analyzed using SPSS v.28 (SPSS Inc., Chicago IL). Results Study included 73,286 injections, with 441 injections (n = 441) resulting in urgent follow-up visits (0.60%). Mean patient age was 72.1 (± 30.4) years, with 187 male (42.4%) and 254 female (57.6%) patients. IVI medications included: aflibercept (60.3%), ranibizumab (22.4%), bevacizumab (13.4%), dexamethasone intravitreal implant (2%), triamcinolone acetonide (1.6%) brolucizumab (1.59%), fluocinolone acetonide intravitreal implant 0.19 mg (0.2%), and fluocinolone acetonide intravitreal implant 0.18 mg (0.03%) (Table 1). Medications associated with urgent visits included: aflibercept (42.9%), bevacizumab (37.4%), ranibizumab (7.9%), dexamethasone intravitreal implant (6.8%), brolucizumab (2.7%), and triamcinolone acetonide (2.3%) (Table 2). Days between injection and urgent follow-up was on average 3.96 ± 2.14 days. Urgent follow-ups included blurred vision in 164 patients (37.2% of urgent visits), flashes, floaters or posterior vitreous detachment (PVD) in 55 (12.5%), pain in 42 (9.5%), 43 (9.8%) corneal abrasions, 33 (7.5%) subconjunctival hemorrhages, corneal dryness or foreign body sensation in 30 (6.6%), endophthalmitis in 20 (4.5%), 18 (4.1%)vitreous hemorrhages, iritis or uveitis in 11 (2.5%), miscellaneous complications in 9 (2.0%), 7 (1.6%) elevated intraocular pressures, choroidal neovascular membrane in 4 (0.9%), 4 (0.9%) retinal detachments or tears, and 2 (0.45%) traumatic cataracts (Table 3). Conclusion IVIs resulted in 0.60% urgent/unscheduled follow-up visits within 7 days of injection. Most common causes were blurred vision and symptoms of PVD. |
| first_indexed | 2024-12-23T19:33:43Z |
| format | Article |
| id | doaj.art-a8d8c5fa65714e41960871d70f72ade3 |
| institution | Directory Open Access Journal |
| issn | 2056-9920 |
| language | English |
| last_indexed | 2024-12-23T19:33:43Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Retina and Vitreous |
| spelling | doaj.art-a8d8c5fa65714e41960871d70f72ade32022-12-21T17:33:51ZengBMCInternational Journal of Retina and Vitreous2056-99202022-01-01811610.1186/s40942-021-00358-wAnalysis of urgent follow up visits and complications after intravitreal injections: a retrospective cohort studyAlexander Miller0Matthew A. Wilneff1Andrew Yazji2Emily Petrinec3Michael Carbone4Chase Miller5Christina McCrossin6Richard Donkor7David G. Miller8Northeastern Ohio Medical UniversityFlorida Atlantic University Charles E. Schmidt College of MedicineNortheastern Ohio Medical UniversityNortheastern Ohio Medical UniversityRetina Associates of Cleveland IncRetina Associates of Cleveland IncRetina Associates of Cleveland IncRetina Associates of Cleveland IncRetina Associates of Cleveland IncAbstract Background Intravitreal injections (IVIs), a common treatment in ophthalmology, result in acute complications and urgent follow-up visits causing significant burden to both patient and physician. We evaluated the incidence of acute complications following IVIs which occurred within seven days of injection. Methods A retrospective cohort study conducted at a private retinal practice, in Cleveland, Ohio. Using the practice management software database, we examined 73,286 injections of patients with unscheduled or urgent visits within 7 days of an injection from August 1st,2018 to August 1st,2020. Data collected included: age, gender, eye, medication injected, diagnosis, reason for urgent follow-up, time between injection and urgent follow-up, and type of anesthesia administered. Data was analyzed using SPSS v.28 (SPSS Inc., Chicago IL). Results Study included 73,286 injections, with 441 injections (n = 441) resulting in urgent follow-up visits (0.60%). Mean patient age was 72.1 (± 30.4) years, with 187 male (42.4%) and 254 female (57.6%) patients. IVI medications included: aflibercept (60.3%), ranibizumab (22.4%), bevacizumab (13.4%), dexamethasone intravitreal implant (2%), triamcinolone acetonide (1.6%) brolucizumab (1.59%), fluocinolone acetonide intravitreal implant 0.19 mg (0.2%), and fluocinolone acetonide intravitreal implant 0.18 mg (0.03%) (Table 1). Medications associated with urgent visits included: aflibercept (42.9%), bevacizumab (37.4%), ranibizumab (7.9%), dexamethasone intravitreal implant (6.8%), brolucizumab (2.7%), and triamcinolone acetonide (2.3%) (Table 2). Days between injection and urgent follow-up was on average 3.96 ± 2.14 days. Urgent follow-ups included blurred vision in 164 patients (37.2% of urgent visits), flashes, floaters or posterior vitreous detachment (PVD) in 55 (12.5%), pain in 42 (9.5%), 43 (9.8%) corneal abrasions, 33 (7.5%) subconjunctival hemorrhages, corneal dryness or foreign body sensation in 30 (6.6%), endophthalmitis in 20 (4.5%), 18 (4.1%)vitreous hemorrhages, iritis or uveitis in 11 (2.5%), miscellaneous complications in 9 (2.0%), 7 (1.6%) elevated intraocular pressures, choroidal neovascular membrane in 4 (0.9%), 4 (0.9%) retinal detachments or tears, and 2 (0.45%) traumatic cataracts (Table 3). Conclusion IVIs resulted in 0.60% urgent/unscheduled follow-up visits within 7 days of injection. Most common causes were blurred vision and symptoms of PVD.https://doi.org/10.1186/s40942-021-00358-w |
| spellingShingle | Alexander Miller Matthew A. Wilneff Andrew Yazji Emily Petrinec Michael Carbone Chase Miller Christina McCrossin Richard Donkor David G. Miller Analysis of urgent follow up visits and complications after intravitreal injections: a retrospective cohort study International Journal of Retina and Vitreous |
| title | Analysis of urgent follow up visits and complications after intravitreal injections: a retrospective cohort study |
| title_full | Analysis of urgent follow up visits and complications after intravitreal injections: a retrospective cohort study |
| title_fullStr | Analysis of urgent follow up visits and complications after intravitreal injections: a retrospective cohort study |
| title_full_unstemmed | Analysis of urgent follow up visits and complications after intravitreal injections: a retrospective cohort study |
| title_short | Analysis of urgent follow up visits and complications after intravitreal injections: a retrospective cohort study |
| title_sort | analysis of urgent follow up visits and complications after intravitreal injections a retrospective cohort study |
| url | https://doi.org/10.1186/s40942-021-00358-w |
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