Mechanisms of sterile inflammation after intravitreal injection of antiangiogenic drugs: a narrative review.
William J AndersonNatasha Ferreira Santos da CruzLuiz Henrique LimaGeoffrey G EmersonEduardo Büchele RodriguesGustavo Barreto MeloPublished in: International journal of retina and vitreous (2021)
The main factors which play a role in intraocular inflammation after anti-VEGF injection can be divided into three causes: patient-specific, medication-specific and delivery-specific. The majority of clinically significant inflammation seen after intravitreal injection is an acute onset inflammatory response with most patients recovering baseline VA in 3-5 weeks. The presence of pain, hypopyon, severe anterior chamber reaction, hyperemia and significant vision loss may help distinguish infectious from non-infectious etiologies of post injection inflammation. Avoiding temperature fluctuation, mechanical shock, agitation during transport and handling of syringes/drugs, and the use of SO-free syringes may help minimize intraocular inflammation. While a definitive mechanism has not yet been established, current knowledge of the clinical presentation and vitreous histopathology of brolucizumab-retinal vasculitis favors an auto-immune type IV hypersensitivity reaction.
Keyphrases
- oxidative stress
- inflammatory response
- vascular endothelial growth factor
- end stage renal disease
- diabetic retinopathy
- healthcare
- ultrasound guided
- drug induced
- chronic kidney disease
- liver failure
- endothelial cells
- squamous cell carcinoma
- optical coherence tomography
- emergency department
- peritoneal dialysis
- pain management
- toll like receptor
- spinal cord injury
- early onset
- prognostic factors
- lps induced
- preterm birth
- gestational age
- adverse drug