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Contact dermatitis in patients undergoing serial intravitreal injections
Jolien Veramme1, Julie de Zaeytijd2, Jo Lambert1
1Department of Dermatology, Ghent University Hospital, B-9000 Ghent, Belgium.
Contact Dermatitis
|October 23, 2015
Summary
Phenylephrine is the most common cause of contact dermatitis from ophthalmic products used in intravitreal injections. This allergy is likely due to its frequent use in repeated eye treatments and follow-up appointments.
Area of Science:
- Ophthalmology
- Dermatology
- Allergology
Background:
- Intravitreal injections using anti-vascular endothelial growth factor (VEGF) medications are standard for retinal pathologies.
- An increase in contact dermatitis cases linked to ophthalmic products used during these procedures has been observed.
- Ghent University Hospital has seen a rise in patients undergoing intravitreal injections since 2006.
Purpose of the Study:
- To determine the specific substance in ophthalmic products responsible for causing contact dermatitis during intravitreal injections.
- To identify the primary allergen triggering adverse skin reactions in patients receiving eye treatments.
Main Methods:
- Patch testing was performed on 16 patients experiencing eyelid swelling, burning, and stinging post-injection.
- Patients were tested with standard, cosmetic, pharmaceutical, and ophthalmic series, including specific eye drops used in the procedure.
Main Results:
- 14 out of 16 patients showed positive reactions to substances used during the injection.
- Phenylephrine was the most frequent allergen, causing reactions in 56% of patients.
- Iso-Betadine® ophthalmic solution and sodium metabisulfite were also identified as allergens in 31% and 16% of patients, respectively.
Conclusions:
- Phenylephrine is identified as the predominant causal allergen in contact dermatitis associated with intravitreal injection procedures.
- The high frequency of phenylephrine application during repeated intravitreal injections and follow-up visits likely contributes to patient sensitization.
