Scleral thinning after repeated intravitreal injections of antivascular endothelial growth factor agents in the same quadrant

Zinkernagel, Martin; Schorno, Petra; Ebneter, Andreas; Wolf, Sebastian (2015). Scleral thinning after repeated intravitreal injections of antivascular endothelial growth factor agents in the same quadrant. Investigative ophthalmology & visual science, 56(3), pp. 1894-1900. Association for Research in Vision and Ophthalmology 10.1167/iovs.14-16204

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PURPOSE We assessed the effects of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy on scleral architecture using spectral domain anterior segment optical coherence tomography (OCT). METHODS A total of 35 eyes of 35 patients treated with at least 30 intravitreal injections in one eye in the inferotemporal quadrant with ranibizumab or aflibercept and 10 or less intravitreal injections in the fellow eye attending the intravitreal injection clinic were included. Enhanced depth imaging anterior segment OCT was used to measure scleral thickness. For each eye the sclera was measured in four quadrants at 3 mm from the limbus. In addition axial eye length was measured in all subjects using partial coherence interferometry. RESULTS The mean number of intravitreal injections was 42 (range, 30-73) and 1.6 (range, 0-9) in the fellow eyes. In the study eyes with more than 30 injections the average scleral thickness in the inferotemporal quadrant was 568.4 μm (SD ± 66 μm) and 590.6 μm (SD ± 75 μm) in the fellow eyes with 10 or less injections (P = 0.003). The mean average scleral thickness in the other three quadrants (inferonasal, superotemporal, and superonasal) was 536.6 μm in the study eyes (SD ± 100 μm) and 545.2 μm (SD ± 109 μm) in the fellow eyes (P = 0.22). There was a borderline association of the total number of injections with scleral thickness change in the inferotemporal quadrant (r = 0.3, P = 0.052). CONCLUSIONS Intravitreal injections may lead to scleral changes when applied repeatedly in the same quadrant. Thus, alternating the injection site should be considered in patients requiring multiple intravitreal injections.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology

UniBE Contributor:

Zinkernagel, Martin; Ebneter, Andreas and Wolf, Sebastian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0146-0404

Publisher:

Association for Research in Vision and Ophthalmology

Language:

English

Submitter:

Sebastian Wolf

Date Deposited:

05 May 2015 14:36

Last Modified:

22 Dec 2015 13:09

Publisher DOI:

10.1167/iovs.14-16204

PubMed ID:

25711641

Uncontrolled Keywords:

retina, anti-VEGF, intravitreal injections, sclera, anterior segment OCT

BORIS DOI:

10.7892/boris.68028

URI:

https://boris.unibe.ch/id/eprint/68028

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