PurposeTo review the risk of systemic adverse events and all-cause mortality following
same-day bilateral anti-VEGF injections.MethodsTwelve literature databases were searched
for studies on same-session bilateral intravitreal anti-VEGF injections. Studies reporting
on systemic adverse events and mortality were included. Data extraction was made independently
by two authors and discussed afterwards until consensus was reached.ResultsSeven studies
were included with a total of 13,406 intravitreal anti-VEGF injections (6703 bilateral
injections sessions) given to 689 patients. Across all studies, mean age of patients
ranged from 55.7 to 82.5 years, and mean follow-up times ranged from 1.3 to 41 months.
Six studies reported on systemic adverse events: Two cases of non-fatal cardiac adverse
events were reported after 12,964 injections (6482 bilateral injection sessions) in
626 patients. Four studies reported on death: 12 deaths were recorded after 6233 bilateral
injection sessions in a total population of 554 subjects.ConclusionsWe suggest that
the risk of non-fatal systemic adverse events and death after same-session bilateral
anti-VEGF injection is reasonably low, but larger studies with follow-ups of several
years are needed to quantify the exact risk.Study registration.Prospectively registered
in PROSPERO, registration ID: CRD42023428254, registration date: 20/05/2023.
