by Mr Anish Shah

Systemic adverse events from eye injections for diabetic macular swelling

This large American claims database based retrospective cohort study examined over 23,000 patients receiving antiVEGF injections for diabetic macular swelling and reassuringly found no increased risk of stroke, heart attack or major bleeding events, when compared with patients receiving macular laser therapy for the same condition: https://pubmed.ncbi.nlm.nih.gov/30292542/ However this study is based on US patients… Read More

by Mr Anish Shah

Anti-VEGF injections for proliferative diabetic retinopathy

Retinal specialists knew that this would be on the cards at some point, but managing proliferative diabetic retinopathy (PDR) with regular intravitreal injections is not standard practice in the UK. This is perhaps due to cost, service pressures, or the fear of non-attendance or service-initiated re-schedulings causing re-proliferation at the retina and subsequent complications such… Read More

by Mr Anish Shah

New anti-VEGF agent for macular degeneration shows promise

Phase 2 studies of brolucizumab show similar efficacy to aflibercept (Eylea) for wet age-related macular degeneration (AMD) and the drug is now advancing to Phase 3 trials. Wet AMD is becoming more prevalent and the higher the number of treatment options, the better. What is interesting is that the brolucizumab group in the study may… Read More

by Mr Anish Shah

The risks of not using iodine during intravitreal injections

Intravitreal injections are frequently administered to patients with wet macular degeneration, retinal vein occlusion or diabetic eye disease. During the injection procedure, povidone-iodine drops are used to disinfect the ocular surface, which reduces the risk of post-injection infection in the eye (endophthalmitis – which is very rare but can cause significant visual loss if it… Read More

by Mr Anish Shah

Avastin (bevacizumab) for wet AMD does not increase risk of stroke or heart attack

One of the largest studies to date to examine the relationship between single or multiple intravitreal injections of Avastin (bevacizumab) for wet macular degeneration, studying several thousand patients from British Columbia in Canada, has not found any increased risk of myocardial infarction (heart attack) or stroke in patients receiving the injections: http://www.ajo.com/article/S0002-9394%2815%2930005-2/abstract This is obviously… Read More

by Mr Anish Shah

Treat-and-Extend injections for wet AMD

There has been increasing interest in the Treat-and-Extend model of dosing of intravitreal injections for wet macular degeneration, which aims to reduce the number of visits for patients while individualising treatment frequency depending on disease activity. This latest randomised clinical trial, although studying small numbers of patients, appears to show that this regimen led to… Read More

by Mr Anish Shah

Intravitreal anti-VEGF injections do not increase risk of stroke, heart attack or death

This is a large and important study from Singapore. When Avastin was given in large doses intravenously for cancer treatment, an increased risk of stroke was observed. Therefore there was a theoretical risk that even the tiny doses of Avastin given into the eye could also be associated with a higher risk of stroke. This… Read More