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Current role of intravitreal injections in Irvine Gass syndrome-CRIIG study

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Abstract

Objective

To analyze the role of intravitreal anti-vascular endothelial growth factor (anti-VEGF) or steroid injection for the management of Irvine Gass syndrome.

Methods

It is an interventional, retrospective, multicenter study. One hundred and thirty-two injections were given in 79 eyes of 72 patients with Irvine Gass syndrome. Patients were treated with at least one intravitreal injection of either anti-VEGF or steroid. Outcomes were measured at 12 months (± 1 week). [Ranibizumab (Lucentis; Genentech, South San Francisco, CA) (Razumab; Intas Pharmaceutical Ltd, Ahmedabad, India) Bevacizumab (Avastin; Genentech, South San Francisco, CA) or Aflibercept (Eylea; Regeneron, Tarrytown, NY)] or steroids [Dexamethasone implant (Ozurdex, Allergan Inc, Irvine, CA) or intravitreal triamcinolone)].

Results

Intravitreal injections were initiated in (67.6%) of eyes within 14 weeks of diagnosis. Intravitreal dexamethasone implant was used as the initial intravitreal therapy in (73.4%) of eyes. More than fifty percent (54.5%) of the patients were switched from anti-VEGF to Intravitreal dexamethasone implant. Reduction in the mean CMT was 336.7 ± 191.7 and 160.1 ± 153.1 microns in eyes treated within four weeks and more than 14 weeks from diagnosis (p = 0.005). Mean ETDRS letter gain was 16.7 ± 12.9 and 5.2 ± 9.2 in eyes treated within 4 weeks and more than 14 weeks from diagnosis (p = 0.004). Three eyes injected with intravitreal dexamethasone implant reported an intraocular pressure spike of > 25 mmHg which was controlled with topical medications. No other ocular or systemic adverse events were observed.

Conclusion

Study results suggest that physicians tend to introduce intravitreal therapy within 14 weeks of diagnosis. The most common therapy at initiation and for the switch is intravitreal dexamethasone implant. Patients treated early (within 4 weeks) respond better in terms of structure and function.

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Abbreviations

CMT:

Central macular thickness

BCVA:

Best-corrected visual acuity

CME:

Cystoid macular edema

IVTA:

Intravitreal triamcinolone acetonide

SD-OCT:

Special-domain optical coherence tomography

*Razumab:

Similar Biologic to Ranibizumab approved in India

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Authors and Affiliations

  1. Lotus Eye Hospital and Institute, Avinashi Road, Coimbatore, Tamil Nadu, 641014, India

    Ashish Sharma, Deepika Makam, Nilesh Kumar & Nikulaa Parachuri

  2. Scientific Institute San Raffaele, University Vita-Salute, Milan, Italy

    Francesco Bandello

  3. Division of Ophthalmology, Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Anat Loewenstein, Dinah Zur & Assaf Hilely

  4. Gavin Herbert Eye Institute, University of California, Irvine, CA, USA

    Baruch D. Kuppermann & Angeline Wang

  5. Department of Ophthalmology, University of Udine, Udine, Italy

    Paolo Lanzetta & Daniele Veritti

  6. Private Retina Service, University of Buenos Aires, Buenos Aires, Argentina

    Matias Iglicki

  7. Rosario Retina Clinic, Rosario, Argentina

    Fernando Miassi

  8. Department of Ophthalmology, Croix-Rousse Hospices Civils de Lyon, University of Lyon, Lyon, France

    David Bellocq, Thibaud Mathis & Laurent Kodjikian

  9. UMR-CNRS 5510 MatéisVilleurbanne, University of Lyon, Lyon, France

    David Bellocq, Thibaud Mathis & Laurent Kodjikian

  10. University of São Paulo Medical School, University of São Paulo, São Paulo, Brazil

    Leandro Cabral Zacharias & Alan K. Barriera

  11. HCLOE Eye Hospital, São Paulo, Brazil

    Alan K. Barriera

  12. Department of Healthcare, The TIPS Global Institute, Coimbatore, Tamil Nadu, India

    Rohini Sharma

  13. College of Pharmacy, Chicago State University, Chicago, IL, USA

    Hafeez Faridi

Authors
  1. Ashish Sharma
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  2. Francesco Bandello
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  3. Anat Loewenstein
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  4. Baruch D. Kuppermann
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  5. Paolo Lanzetta
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  6. Dinah Zur
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  7. Assaf Hilely
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  8. Matias Iglicki
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  9. Daniele Veritti
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  10. Angeline Wang
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  11. Fernando Miassi
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  12. David Bellocq
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  13. Leandro Cabral Zacharias
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  14. Deepika Makam
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  15. Nilesh Kumar
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  16. Nikulaa Parachuri
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  17. Alan K. Barriera
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  18. Rohini Sharma
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  19. Hafeez Faridi
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  20. Thibaud Mathis
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  21. Laurent Kodjikian
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Corresponding author

Correspondence to Ashish Sharma.

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Conflict of interest

BD Kuppermann: clinical research: Alcon, Alimera, Allegro, Allergan, Apellis, Clearside, Genentech, GSK, Ionis, jCyte, Novartis, Regeneron, ThromboGenics; consultant: Alimera, Allegro, Allergan, Cell Care, Dose, Eyedaptic, Galimedix, Genentech, Glaukos, Interface Biologics, jCyte, Novartis, Ophthotech, Regeneron, Revana, Theravance Biopharma, Francesco Bandello: consultant: Allergan, Bayer, Boehringer-Ingelheim, Fidia Sooft, Hofmann La Roche, Novartis, NTC Pharma, Sifi, Thrombogenics, Zeiss. Anat Loewenstein: consultant: Allergan, Novartis, Roche, Notal Vision, Fiorsightslabs, Beyeonics, Bayer Health Care. Ashish Sharma: consultant: Allergan, Novartis, Intas, Bayer Health Care. Rest all other authors have no conflict of interest.

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This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study.

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Sharma, A., Bandello, F., Loewenstein, A. et al. Current role of intravitreal injections in Irvine Gass syndrome-CRIIG study. Int Ophthalmol 40, 3067–3075 (2020). https://doi.org/10.1007/s10792-020-01491-5

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  • DOI: https://doi.org/10.1007/s10792-020-01491-5

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