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  • Anti-VEGF Protocols in Current Practice

    By Jean Shaw
    Selected By: Andrew P. Schachat, MD
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    Journal Highlights

    Ophthalmology Retina, August 2019

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    Uhr et al. evaluated current practice patterns and safety protocols used by retina specialists who administer intravitreal injections of anti-VEGF medications. They found that physicians who have been in practice for 16 or more years are more likely to follow outdated protocols, and that physicians who practice in an academic setting are more likely to use protective wear during the procedure.

    For this study, the researchers surveyed members of the American Society of Retina Specialists. Of 2,782 members, 399 responded, for a 14.3% response rate. Nearly 80% of those who responded practiced in the United States, and almost 60% had been prac­ticing for more than 16 years.

    Overall, the results indicate a grow­ing awareness of the potentially harm­ful effects of topical antibiotics. For instance, only 10.9% of respondents reported that they “always or often” use preinjection antibiotics, and 16.6% said that they instill topical antibiotics immediately after injection. However, later-career ophthalmologists were more likely to continue using an­tibiotics: For instance, 13.7% of those who had practiced for 16 or more years used preinjection antibiotics, compared to 6.7% of those who were newer to practice. Postinjection antibiotics were used by 18.4% of those who had prac­ticed for 16 or more years, compared to 14% of those who had 0-15 years in practice.

    A similar pattern was noted in the practice of scrubbing a patient’s eyelids or lashes with an antiseptic before administering an injection and the use of povidone-iodine. Later-career physicians were more likely to scrub a patient’s eyelids or lashes with an antiseptic than were younger physicians (43.6% vs. 30.5%). In addition, retina specialists in practice longer were less likely to use povidone-iodine before injection than were their younger counterparts (89.7% vs. 95.7%).

    Finally, as for protective wear, a U.S. consensus panel has recommended either the use of a mask or, if one is not used, a no-talking policy during intra­vitreal injections. Academic providers were more likely than those practicing in the community to wear a mask (43% vs. 29.9%)—and of all providers who do not wear a mask, only two-thirds abide by a no-talking policy.

    The original article can be found here.