[Avoiding mistakes in anti-VEGF intravitreal injection therapy]

Area of Science:

• Ophthalmology
• Medical Diagnostics

Background:

• Intravitreal injection (IVI) is a frequent surgical procedure for chronic macular diseases.
• Treatment often involves continuous, long-term administration of anti-vascular endothelial growth factor (VEGF) agents.
• This necessitates significant resource allocation (spatial, personnel, financial).

Purpose of the Study:

• To identify and illustrate common misinterpretations in diagnosing macular diseases and disease activity.
• To highlight potential errors in the indication and continuation of anti-VEGF IVI treatments.
• To raise awareness of differential diagnoses in macular disease management.

Main Methods:

• Analysis of diagnostic interpretations using spectral domain optical coherence tomography (SD-OCT).
• Review of clinical assessment and fluorescence angiography in relation to IVI indications.
• Case study presentations of misdiagnosed or incorrectly treated macular conditions.

Main Results:

• Misinterpretation of SD-OCT findings can lead to inappropriate initiation or continuation of anti-VEGF therapy.
• Underutilization of fluorescence angiography may contribute to diagnostic errors.
• Established treatment indications are rarely re-evaluated, potentially leading to prolonged unnecessary treatments.

Conclusions:

• Accurate interpretation of macular diagnostics, including SD-OCT and angiography, is crucial for appropriate IVI treatment.
• Clinicians should be vigilant for diagnostic misinterpretations and consider differential diagnoses.
• Periodic re-evaluation of IVI treatment indications is necessary to avoid overtreatment.