Providing Safe and Effective Intravitreal injections - Episode 1

Intravitreal Injections’ Impact on Retinal Eye Disorders

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Nadia K. Waheed, MD, MPH, and David M. Brown, MD, discuss how intravitreal injections have changed the treatment landscape of retinal eye disorders.

Nadia K. Waheed, MD, MPH: Hello and thank you for joining Ophthalmology Times™ Insights on Providing Safe and Effective Intravitreal Injections. I’m Dr Nadia K. Waheed. I am a professor of ophthalmology at Tufts University School of Medicine, and I practice at the New England Eye Center in Boston, Massachusetts. I’m joined by Dr David Brown, an ophthalmologist at Retina Consultants of Texas, in Houston. Our discussion today will be about the proper use of intravitreal injections and how to use them safely and effectively. David, I have a quick question for you. All of us are using intravitreal injections quite routinely in our clinical settings. How have intravitreal injections changed the treatment landscape for retinal eye disorders?

David M. Brown, MD: It’s been an incredible paradigm shift. Before, with macular degeneration, patients went blind. Before, with diabetic retinopathy, you did only lasers, which just kind of slowed down the progression to blindness. Now, you actually have patients that improve vision and maintain—there’s not a problem, which is a good thing. We’re kind of like chemotherapy experts, but the patients don’t die. For example, somebody meets you with new wet age-related macular degeneration [AMD] and you have that patient for the rest of their life, often in a 1-month, 10-week sort of rotation. There is a lot of burden to that. It’s more of a burden to the families that have to figure out how we get grandma to the office. Oftentimes, for the patients, it’s their one time out of the nursing home or whatever; the patients really don’t seem to mind the visits as much, but there is a lot of family caregiving in terms of keeping up with these regimens.

Nadia K. Waheed, MD, MPH: And we’re going to see more and more possibly coming to a clinic as these intravitreal injections get approved, potentially for more pathologies such as even dry AMD. It looks like the burden of treatment will certainly continue to increase. I remember when we started out giving interventional injections, I was, I believe, a resident or fellow at that time. And it would be quite an elaborate procedure. We would set the patient up, we would drip them, we would prep them. There was a significant concern around adverse events and potentially developing endophthalmitis. But of course, as we’ve injected these patients, we’ve seen that they’re actually quite safe, and that the incidence of adverse events is quite low.

Transcript Edited for Clarity