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Presumed Silicone Oil Droplets After Intravitreal Pegcetacoplan Injections.

Amr Dessouki¹, Lingmin He¹, Kaitlyn Park¹

¹Retinal Diagnostic Center, Campbell, California.

JAMA Ophthalmology

|October 5, 2023

Summary

Intravitreal pegcetacoplan injections may cause silicone oil droplets, leading to floaters in 29% of patients. Consider silicone-free syringes to mitigate this common complication.

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Area of Science:

Ophthalmology
Retinal Diseases
Pharmacology

Background:

Pegcetacoplan is the first FDA-approved drug for geographic atrophy in age-related macular degeneration.
Intravitreal injections of pegcetacoplan may lead to posttreatment complications.

Purpose of the Study:

To determine the occurrence of silicone oil droplets in the vitreous after intravitreal pegcetacoplan injections.
To assess associated symptoms and visual outcomes.

Main Methods:

Retrospective case series of 55 patients receiving 62 intravitreal pegcetacoplan injections.
Injections administered using a 1-mL McKesson Luer lock syringe.
Patients monitored for silicone droplets, symptoms, visual acuity, and intraocular pressure.

Main Results:

29% of patients (16/55) developed presumed intravitreal silicone droplets 2-4 weeks post-injection.
14 of 16 affected patients experienced symptomatic persistent floaters.
No significant changes in visual acuity or intraocular pressure were observed.

Conclusions:

A notable percentage of patients experienced symptomatic floaters due to silicone droplets after pegcetacoplan injections.
Informing patients about this potential adverse effect is recommended.
Consideration should be given to using silicone-free syringes for pegcetacoplan administration.