Evaluation of Optive® in ocular discomfort after anti-VEGF intravitreal injection
Reviewed by Sofia Rokerya

In this study the authors prospectively evaluated the efficacy of Optive® eye drops after in full, then abbreviation - intravitreal injection (IVT). Patients naïve to IVT were included in the study. No artificial tear treatment was prescribed after the first IVT. After the second IVT, all patients instilled three drops per day of carboxymethylcellulose (CMC) and glycerin (Optive®) for three days. Forty-five patients (mean age 72.3 years [range 23–94], 20 males and 25 females) were included in the study; 62.2% had wet age-related macular degeneration, 13.3% had central retinal vein occlusion (CRVO), 11.1% had retinal vein occlusion (RVO), 4.4% were treated for myopic choroidal neovascularisation (CNV) and 8.9% received treatment for diabetic macular oedema. Every patient answered a questionnaire concerning the ocular discomfort at 72 h after both IVTs and a questionnaire about tolerance to treatment after the second IVT. Twenty patients (44.4%) reported a watery eye, 24 (53.3%) reported a feeling of grittiness and 37 (82.2%) reported other kinds of discomfort after the first IVT. At 72 h after the second treatment IVT, with Optive®, 12 patients (29.3%) reported a watery eye, 13 (31.7%) reported a feeling of grittiness, and 28 (68.3%) reported other kinds of discomfort. Fourteen (34.1%) patients reported a feeling of grittiness after the first IVT treatment and did not report that same feeling after instillation of Optive®. This association was significant (p=0.01). Twelve patients (29.3%) complained of at least one of the ocular discomfort items after the first injection and the second one with Optive® (p=0.14). Eleven patients (26.8%) complained of a watery eye after the first IVT but not after the second with Optive® (p=0.21). For Optive® treatment, seven patients reported an unpleasant contact, consisting in temporary blurred vision (n=2), burning (n=5), and hyperviscosity (n=1). No case of corneal ulcer or endophthalmitis was reported. This study seems to be a way forward to improve patient comfort and compliance for IVT and paves the way for a future comparative study between the use of different lubricants, post treatment. Limitations: Small cohort, lack of clinical check-up at three days post IVT. The patient questionnaire allowed patients to act as their own control and was primarily aimed to reduce a selection bias, but may have introduced a subjective reporting bias.

Evaluation of Carboxymethylcellulose Sodium plus Glycerin (Optive®) in ocular discomfort after anti-vascular endothelial growth factor intravitreal injection therapy.
Karcenty M, Jung C, Souieda EH, et al.
OPHTHALMOLOGICA
2021;244:187-92.