Background: Intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF) now improve or\nstabilize visual acuity in a number of previously untreatable eye diseases, of which the main are age-related macular\ndegeneration, retinal vein occlusion and diabetic macular edema. Most patients require multiple injections over\nlengthy periods of time and the prevalence of treatable conditions is increasing. Anti-VEGF IVI normally\nadministered by physicians, therefore represent a considerable workload on ophthalmologic clinics and will\ncontinue to do so in the near future. Nurse-administered IVI may relieve this workload, but the safety, cost and\npatient satisfaction of such an extended role for nurses in ophthalmologic clinics has not earlier been investigated.\nTo investigate these outcomes following independent anti-VEGF IVI by trained nurses, a noninferiority randomized\ncontrolled trial is being conducted.\nMethods/Design: Patients eligible for anti-VEGF treatment, minimum 304, are recruited and randomized to IVI\nadministration by either trained nurses or physicians. The primary outcome is safety, measured by difference in\nmean change in visual acuity between the two groups during an observation period of 12 months. Secondary\noutcomes are incidence of ocular adverse events, cost per patient and patient satisfaction.\nDiscussion: This study protocol describes the design of the first randomized controlled trial of nurse-administered\nIVI of anti-VEGF. The study is designed to examine safety, cost and patient satisfaction during 12 months follow-up.
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