Authors
Bobykin E.V., Korotkikh S.A., Morozova O.V., Akimenko I.A.
Ural State Medical University, Yekaterinburg
Abstract
Intravitreal drug injections are one of the most common procedures in daily ophthalmic practice. With the increase in the number of manipulations, the expansion of indications for them, as well as the registration of new drugs, the problem of inflammatory adverse events, including sterile intraocular inflammation, brolucizumab-associated retinovasculitis, and post-injection infectious endophthalmitis, becomes more and more urgent. Their timely diagnosis and treatment is impossible without knowledge of the clinical manifestations and existing therapeutic options. This review provides a brief description of current approaches to the prevention, differential diagnosis and treatment of various forms of inflammatory adverse events associated with intravitreal drug administration. The emphasis is on recommendations developed by Russian specialists.
Keywords: intravitreal injection; protocol; intraocular inflammation; brolucizumab; differential diagnosis; algorithm; uveitis; endophthalmitis; retinovasculitis.
References
1. Spravochnyj portal po zdravoohraneniju i medicine ZdravMedInform. https://zdravmedinform.ru/nomenclatura-meditcinskikh-uslug.html [Nomenklatura medicinskih uslug (novaja redakcija)..
2. Neroev VV, Astakhov YuS , Korotkih SA, et al. Protocol of intravitreal drug delivery. Consensus of the Expert Counsil of Retina and Optic Nerve Diseases of the All-Russian Public Organasation «Association of Ophthalmologists». The Russian Annals of Ophthalmology. 2020;136(6):251–263. (In Russ.) DOI: 10.17116/oftalma 2020136062251.
3. Neroev VV, Korotkikh SA, Bobykin EV, et al. An Information leaflet for patients receiving treatment by intravitreal drug injections. Recommendations of the Expert Council on retinal and optic nerve diseases of the Association of Ophthalmologists, an All-Russian public organization. Russian ophthalmological journal. 2021;14(2 suppl.):7–19 (In Russ.) DOI: 10.21516/2072-0076-2021-14-2-supplement-7-19.
4. Neroev VV, Zaytseva OV, Bobykin EV, et al. Results of clinical approbation of information leaflet for patients treated with intravitreal injections of drugs. Russian ophthalmological journal. 2021;14(2 suppl.):20–28 (In Russ.) doi: 10.21516/2072-0076-2021-14-2-supplement-20-28.
5. Drozdova E.A., Zajceva O.V., Kuznecova T.I., et al. Neinfekcionnoe vnutriglaznoe vospalenie na fone intravitreal’nogo vvedenija lekarstvennogo preparata. Posobie dlja vrachej-oftal’mologov. — Moscow: OOO «Novartis Farma»; 2021. (In Russ.)
6. Kilmartin DJ. Literature review and proposal of best practice for ophthalmologists: monitoring of patients following intravitreal brolucizumab therapy. Ir J Med Sci. Forthcoming 2022. doi: 10.1007/s11845-022-02929-8.
7. Sharma A, Kumar N, Parachuri N, et al. Brolucizumab-foreseeable workflow in the current scenario. Eye (Lond). 2021;35(6):1548-1550. doi: 10.1038/s41433-020-01324-w.
8. Astakhov YS, Belekhova SG, Litvinova EA. Infectious and sterile endophthalmitis after intravitreal injections: differential diagnosis, prevention, treatment. Ophthalmology Journal. 2017;10(1):62-69. (In Russ). doi:10.17816/OV10162-69.
9. Maljugin BJe, Shpak AA, Morozova TA Hirurgija katarakty: kliniko-farmakologicheskie podhody. Moscow: Izdatel’stvo «Oftal’mologija»; 2015. (In Russ).
10. Klinicheskie rekomendacii «Uveity neinfekcionnye». Obshherossijskaja obshhestvennaja organizacija «Associacija vrachej-oftal’mologov». http://avo-portal.ru/doc/fkr/item/373-uveity-neinfektsionnye.
11. Baumal CR, Bodaghi B, Singer M, et al. Expert Opinion on Management of Intraocular Inflammation, Retinal Vasculitis, and Vascular Occlusion after Brolucizumab Treatment. Ophthalmol Retina. 2021;5(6):519-527. doi: 10.1016/j.oret.2020.09.020.
12. Monés J, Srivastava SK, Jaffe GJ, et al. Risk of Inflammation, Retinal Vasculitis, and Retinal Occlusion-Related Events with Brolucizumab: Post Hoc Review of HAWK and HARRIER. Ophthalmology. 2021;128(7):1050-1059. doi: 10.1016/j.ophtha.2020.11.011.
13. Abicipar pegol not approved for treatment of wet AMD. Available at: https://www.healio.com/news/ophthalmology/20200626/abicipar-pegol-not-approved-for-treatment-of-wet-amd#:~:text=Citing%20an%20unfavorable%20benefit%2Drisk,neovascular%20age%2Drelated%20macular%20degeneration. Accessed October 31, 2022.
14. Novartis Terminates Three Trials of Beovu Despite Meeting Primary Endpoint of MERLIN Trial. Available at: https://eyewire.news/articles/novartis-terminates-three-trials-of-beovu-despite-meeting-primary-endpoint/?c4src=article:infinite-scroll. Accessed October 31, 2022.
15. Genentech Announces US FDA Approval of Port Delivery System, Now Named Susvimo. Available at: https://www.market-scope.com/dashboard#/articles/5662/genentech-announces-us-fda-approval-of-port-delivery-system-now-named-susvimo. Accessed October 31, 2022.
16. Genentech Recalls Susvimo Implant After Finding Seal Can Leak. Available at: https://www.market-scope.com/dashboard#/articles/6449/genentech-recalls-susvimo-implant-after-finding-seal-can-leak. Accessed October 31, 2022.
17. Ostroumova OD, Chikh EV, Rebrova EV, et al. Drug-induced uveitis. Vestnik Oftalmologii. 2021;137(1):94-101. (In Russ.) doi: 10.17116/oftalma202113701194.
