Bilateral anti-VEGF injections safe, preferable to unilateral injections

Retina. 2011;31(1):31-35.

Patients preferred same-day bilateral intravitreal injections of anti-VEGF agents over unilateral injections, a study found.

"In summary, patients who received bilateral injections of anti-VEGF agents had the same systemic and ocular [adverse event] profile as patients who received unilateral injections," the study authors said.

The retrospective study included 102 patients with exudative age-related macular degeneration who received bilateral anti-VEGF injections on the same day for 23 months.

Average patient age was 81.1 years in the bilateral injection group. A total of 452 bilateral injections, or 904 injections total, were administered. These patients received an average of 4.4 bilateral injections. Avastin (bevacizumab, Genentech) was injected 206 times bilaterally and Lucentis (ranibizumab, Genentech) was injected 206 times bilaterally; 40 bilateral injections were given with bevacizumab in one eye and ranibizumab in the other.

A comparator group comprised 102 patients who underwent unilateral injections. Average patient age was 82 years. A total of 1,009 unilateral injections were administered. These patients received an average of 10.2 injections. Bevacizumab was injected 508 times, and ranibizumab was injected 501 times.

Average follow-up for both groups was 18.4 months.

Study results showed systemic adverse event rates of 1.96% in the bilateral injection group and 2.94% in the unilateral injection group. However, the between-group difference was statistically insignificant.

Ninety-one patients in the bilateral injection group expressed a preference for bilateral injections in one visit as opposed to unilateral injections over two visits, the authors reported.