Fluorescein angiography essential to identify retinal vasculitis
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FORT LAUDERDALE, Fla. — Rare cases of occlusive retinal vasculitis have occurred with intravitreal therapies, and fluorescein angiography is an important tool to identify and diagnose the condition, according to a speaker here.
At the Retina World Congress, Thomas A. Albini, MD, said that several factors may make post-injection retinal vasculitis difficult to diagnose, including no consensus on a diagnostic definition.
“Is that staining of the vessel? Is that leakage of the vessel? For a lot of these things, there is no consensus,” he said.
Other factors that make retinal vasculitis difficult to diagnose include a decline in the use of fluorescein angiography, a lack of an accepted grading system for the condition and inconsistent image quality limited by inflammation.
According to Albini, previous findings determined that vision loss due to retinal vasculitis following an intravitreal injection was more likely to occur in women, as well as patients with prior uveitis. Patients experienced ocular discomfort or pain, a delayed onset, anterior chamber and vitreous cell, and cuffing and sheathing of arteries and veins.
“Many of these findings could be easily overlooked if a fluorescein angiogram wasn’t obtained,” Albini said.
He also described a case in which a patient diagnosed with occlusive retinal vasculitis had endophthalmitis.
Ophthalmologists should report all cases of retinal vasculitis to the FDA, the drug’s sponsor company and organizations such as the American Society of Retina Specialists Research and Safety in Therapeutics Committee.
Regarding gene therapy, “as these phase 2 programs mature into phase 3 and into FDA approval, we need to better understand the optimal mode of delivery, the optimal vector and also the optimal anti-inflammatory prophylaxis, which is not yet clear but is something that is going to be needed,” he said.
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Albini TA. Safety concerns in retinal pharmacotherapy. Presented at: Retina World Congress; May 9-12, 2024; Fort Lauderdale, Florida.
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