Evaluation of pain during intravitreal Ozurdex injections vs intravitreal bevacizumab injections

• Published in: Eye (London) Vol. 28; no. 8; pp. 980 - 985
• Main Authors: Moisseiev, E, Regenbogen, M, Rabinovitch, T, Barak, A, Loewenstein, A, Goldstein, M
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.08.2014; Nature Publishing Group
• Subjects: 692/1807/410; 692/699/3161; 692/700/565/1436; Adult; Aged; Aged, 80 and over; Anesthetics, Local - administration & dosage; Angiogenesis Inhibitors - administration & dosage; Antibodies, Monoclonal, Humanized - administration & dosage; Bevacizumab; Clinical Study; Dexamethasone - administration & dosage; Drug Implants; Eye Pain - diagnosis; Female; Glucocorticoids - administration & dosage; Humans; Intravitreal Injections; Laboratory Medicine; Lidocaine - administration & dosage; Macular Edema - drug therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Pain Measurement; Pharmaceutical Sciences/Technology; Retinal Vein Occlusion - drug therapy; Surgery; Surgical Oncology; Vascular Endothelial Growth Factor A - antagonists & inhibitors
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2014.129

Purpose The purpose was to evaluate the pain associated with intravitreal Ozurdex injections, and to compare it with that associated with intravitreal bevacizumab injections. Methods The study included 57 eyes of 57 patients who received an intravitreal Ozurdex injection at our institution. Pain was measured by the visual analog scale (VAS). Additional parameters recorded included age, sex, indication for the injection, number of previous Ozurdex injections in the study eye, presence of diabetes mellitus, and lens status. Data were compared with a 2 : 1 sex- and age-matched control group of 114 patients who received intravitreal bevacizumab injections. Results Indications for injection included diabetic macular edema (40.4%) and macular edema secondary to central and branch retinal vein occlusion (28% and 31.6%, respectively). Pain scores on the VAS ranged from 0 to 90, with a mean of 20.8±20.3. There was no significant difference in pain between Ozurdex and bevacizumab injections. Pseudophakia was correlated with increased pain in Ozurdex injections. Conclusions This is the first series evaluating the pain associated with intravitreal Ozurdex injections. Despite a larger needle gauge and tunneled injection technique, intravitreal injection of Ozurdex is not associated with increased pain compared with bevacizumab. This finding may be a potential advantage for Ozurdex, and may serve to improve patient compliance with future long-term treatment protocols.