The number of IVT injections, diagnoses, visual acuity and safety profiles are shown in Figures 10.1 and 10.2 and in Tables 10.1 and 10.2.
Among the number of IVT injections performed from 2006 to 2012 at SNEC, Avastin* (bevacizumab) injections were most widely used.
Of the 1,085 anti-VEGF injections administered, the most common diagnosis treated was AMD.
Three months after treatment, one out of three patients demonstrated a gain of ≥ 15 letters in their visual acuity (Cheung et al., 2014)
Anti-VEGF injections performed in 1,182 patients demonstrated a good safety profile, with the majority of patients receiving Avastin* (bevacizumab) (n = 1,011) (Ng et al., 2015).
VEGF, vascular endothelial growth factor.
From January 2005 to September 2013, 16, 304 IVT injections were performed. Only one case of endophthalmitis (culture positive) was reported for an overall incidence of 0.006%.
SNEC’s patient cohort achieved a significant improvement in visual acuity after one year of treatment; however, there was no significant difference in the mean visual acuity change when outcomes were analysed by diagnosis of AMD-choroidal neovascularisation versus PCV.
AMD, age-related macular degeneration; CNV, choroidal neovascularisation; ETDRS, Early Treatment Diabetic Retinopathy Study; IVT, intravitreal; PCV, polypoidal choroidal vasculopathy; SD, standard deviation,; VA, visual acuity; VEGF, vascular endothelial growth factor.
The pivotal Minimally Classic/Occult Trial of the Anti-VEGF Antibody Ranibizumab in the Treatment of Neovascular Age-Related Macular Degeneration (MARINA) study, carried out in the USA in patients with AMD treated with 0.3 or 0.5mg Lucentis® (ranibizumab), demonstrated a mean increase in visual acuity of 6.5 letters in the 0.3mg group and 7.2 letters in the 0.5 mg group (Rosenfield et al., 2006).
Although not a direct comparison, improvement in vision from the SNEC cohort was +8 letters at three months and +6.5 letters at 12 months.
The overall incidence rate of endophthalmitis post-IVT injection is very low at 0.018% (3/16,304), which is below the rate reported in a meta-analysis of 0.056% (Fileta, Scott, & Flynn, 2014).
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