Reflux of drug during intra-vitreal anti-VEGF therapies

To report reflux of anti-VEGF drug during intravitreal injections.

Review of electronic case notes of patients undergoing intra-vitreal anti-VEGF treatments. Prospective data collection was performed with a specific emphasis on presence or absence of reflux.

152 records of 102 eyes were available from an 8-month period. 119 Ranibizumab injections and 33 bevazicumab injections were considered. Reflux was noted in 48 injections (31%). For eyes with first injection of anti-VEGF agent, reflux was noted in 9/23 eyes. Eyes with at least one previous injection were observed to have reflux in 24/79 eyes. Presence of reflux was statistically tested against posterior vitreous detachment and phakic status and was found to be statistically insignificant.

Intra-vitreal anti-VEGF injections with volumes of 0.05  ml appears to produce displacement of the conjunctiva with a transient fluid-filled bleb immediately after the injection in approximately 1/3 of eyes.