Practice patterns for intravitreal injections in Argentina: results from a national survey of the Argentine Council of Ophthalmology

Abstract

Objective: To assess current practices of intravitreal injections (IVI) and related complications among ophthalmologists in Argentina.
Methods: In 2016, an anonymous web-based 39-question survey was designed using Google Forms tool and made accessible to 5,436 affiliated ophthalmologists to the Argentine Council of Ophthalmology currently practicing in Argentina. The questionnaire inquired on demographic information concerning the treating physician (age, gender, subspecialty practice, etc.), the procedure (number of IVI/month, treated disease, injected drugs, facility, technique/instrumentation (antisepsis, lid speculum, sterile gloves, and mask) and complications.
Results: 438 (8.05%) ophthalmologists responded the survey, 87.7% of whom perform IVI; 66.4% were middle-aged physicians, and 20.3% Retina specialists. The most frequently treated disease is age-related macular degeneration, followed by diabetic macular edema. Off-label drugs are used by 54.4%. IVI are performed in the OR by 82.8%. Povidone-iodine is used by 97.7%, a sterile lid speculum 89%, sterile gloves 92.7%, a mask in 88%. Complications during the procedure were reported by 18.7% of respondents, being conjunctival hemorrhage the commonest (93.1%). Post injection complications were reported by 25.8% of respondents, and these complications included ocular hypertension and endophthalmitis.
Conclusions: Surveyed-based estimates about usual practices of ophthalmologists in Argentina performing IVI and some of the related complications were obtained. Disparities in current practices of IVI were frequent. The majority of respondents agreed in performing injections in the OR, the use of topical povidone-iodine and lid speculum. Performing more than 20 injections per month, practicing Retina/Vitreous subspecialty and not using a lid speculum, were more frequently associated with endophthalmitis.