Priya Samalia1, David Garland2, David Squirrell3. 1. Ophthalmology Department, Dunedin Public Hospital, 201 Great King Street, Dunedin, New Zealand. prapri14@gmail.com. 2. Department of Ophthalmology, Greenlane Clinical Centre, Auckland, New Zealand. 3. Department of Ophthalmology, Greenlane Clinical Centre, Auckland and University of Auckland Department of Ophthalmology, Auckland.
Abstract
AIM: The number of individuals with chronic conditions such as age-related macular degeneration (AMD) is increasing, and consequently the treatment burden for anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections is also increasing. The use of nurse specialists to administer anti-VEGF intravitreal injections has been proposed to address this treatment burden. This was a prospective safety audit to determine the safety of nurse specialists for the delivery of anti-VEGF intravitreal injections. METHOD: A prospective safety audit was undertaken for a nurse specialist-delivered injection service in the Ophthalmology Clinic, Greenlane Clinical Centre. The department's senior medical retinal consultant supervised the nurse specialist training programme. The clinical safety of anti-VEGF intravitreal injections delivered by nurse specialists, and the impact of this programme on clinical capacity at our Institute was reviewed. RESULTS: The nurse specialists administered a total of 2,900 injections over an 18-month period. Two patients developed endophthalmitis post injection (1 infective, 1 non-infective). Two patients had a vitreous haemorrhage, and five patients had raised intraocular pressure. The incidence of post-injection endophthalmitis, vitreous haemorrhage and raised intraocular pressure was 0.07%, 0.07% and 0.17%, respectively. CONCLUSION: The nurse specialist-delivered injection service is a safe and effective service for treatment of wet AMD, diabetic macular oedema and vein occlusion.
AIM: The number of individuals with chronic conditions such as age-related macular degeneration (AMD) is increasing, and consequently the treatment burden for anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections is also increasing. The use of nurse specialists to administer anti-VEGF intravitreal injections has been proposed to address this treatment burden. This was a prospective safety audit to determine the safety of nurse specialists for the delivery of anti-VEGF intravitreal injections. METHOD: A prospective safety audit was undertaken for a nurse specialist-delivered injection service in the Ophthalmology Clinic, Greenlane Clinical Centre. The department's senior medical retinal consultant supervised the nurse specialist training programme. The clinical safety of anti-VEGF intravitreal injections delivered by nurse specialists, and the impact of this programme on clinical capacity at our Institute was reviewed. RESULTS: The nurse specialists administered a total of 2,900 injections over an 18-month period. Two patients developed endophthalmitis post injection (1 infective, 1 non-infective). Two patients had a vitreous haemorrhage, and five patients had raised intraocular pressure. The incidence of post-injection endophthalmitis, vitreous haemorrhage and raised intraocular pressure was 0.07%, 0.07% and 0.17%, respectively. CONCLUSION: The nurse specialist-delivered injection service is a safe and effective service for treatment of wet AMD, diabetic macular oedema and vein occlusion.
Authors: Omer Trivizki; Michael R Karp; Anuj Chawla; Justin Yamanuha; Giovanni Gregori; Philip J Rosenfeld Journal: Am J Ophthalmol Date: 2020-07-02 Impact factor: 5.258