Diabetic Retinopathy Clinical Trial
Official title:
Conjunctival Flora Patterns After Serial Intravitreal Injections Without Postinjection Topical Antibiotics in Diabetic Patients
The aim of this study is to investigate the conjunctival bacterial flora and antibiotic resistance patterns following serial intravitreal injections of anti-VEGF in diabetic patients, using a povidone-iodine preparation without preinjection or postinjection topical antibiotics.
The study is designed to enroll patients with Diabetes Mellitus over 18 years of age with
diagnosis of diabetic retinopathy and diabetic macular edema, who were determined by their
treating physician to require at least 3 serial injections with an anti-VEGF agent.
After signing an informed consent, conjunctival cultures will be performed from the
participants' both eyes at baseline and at each subsequent injection. Prior to each
injection and the use of povidone-iodine drops, a conjunctival culture will be taken by
swabbing the inferior fornix. Another culture will be taken twenty minutes after the
injection. We will culture the swab samples on blood and chocolate agar plates.
All patients will be asked to complete a questionnaire regarding their signs and symptoms
after the injection (like burning sensation, itching, discharge, tearing etc). The following
routine procedure will be used in all intravitreal injections: local anesthesia using
Oxybuprocaine hydrochloride, ocular surface and eyelids sterilization with topical
povidone-iodine 4%. Intravitreal injection of 3.5 mm will be performed posterior to the
limbus in pseudophakic patients and 4 mm injection will be performed posterior to the limbus
in phakic patients using a 30 gauge needle.
The exclusion criteria will consist patients who had received a prior intraocular injection
in either eye, current use of contact lenses, chronic use of any ophthalmic medication,
ocular surgery within the past 6 months, use of systemic antibiotics within the past 6
months and known allergy or contraindication to povidone-iodine or proparacaine.
The study is planned to enroll 50 patients.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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