玻璃体内注射技术与监测：专家小组的更新指南

Intravitreal injection technique and monitoring: updated guidelines of an expert panel.

作者信息

Avery Robert L, Bakri Sophie J, Blumenkranz Mark S, Brucker Alexander J, Cunningham Emmett T, DʼAmico Donald J, Dugel Pravin U, Flynn Harry W, Freund K Bailey, Haller Julia A, Jumper J Michael, Liebmann Jeffrey M, McCannel Colin A, Mieler William F, Ta Christopher N, Williams George A

机构信息

*California Retina Consultants and Research Foundation, Santa Barbara, California; †Mayo Clinic, Rochester, Minnesota; ‡Byers Eye Institute, Stanford University School of Medicine, Stanford, California; §Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; ¶California Pacific Medical Center, San Francisco, California; **The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California; ††West Coast Retina, San Francisco, California; ‡‡Weill Cornell Medical College, New York-Presbyterian Medical Center, New York, New York; §§Keck School of Medicine, University of Southern California, Los Angeles, California; ¶¶Bascom Palmer Eye Institute, University of Miami, Miami, Florida; ***Vitreous-Retina-Macula Consultants of New York, New York; †††Wills Eye Hospital, Philadelphia, Pennsylvania; ‡‡‡Manhattan Eye, Ear & Throat Hospital, New York University Medical Center, New York, New York; §§§Jules Stein Eye Institute, University of California, Los Angeles, California; ¶¶¶University of Illinois, Chicago, Illinois; ****Stanford University School of Medicine, Stanford, California; and ††††Oakland University William Beaumont School of Medicine, Beaumont Eye Institute, Royal Oak, Michigan.

出版信息

Retina. 2014 Dec;34 Suppl 12:S1-S18. doi: 10.1097/IAE.0000000000000399.

DOI:10.1097/IAE.0000000000000399

PMID:25489719

Abstract

PURPOSE

To review evidence and provide updated guidelines on intravitreal (IVT) injection technique and monitoring.

METHODS

A review of the published literature on IVT injection from 2004 to 2014 formed the basis for round table deliberations by an expert panel of ophthalmologists.

RESULTS

The dramatic increase in the number of IVT injections has been accompanied by a comparable increase in evidence surrounding IVT practice patterns and techniques. The expert panel identified a number of areas that have evolved since publication of the original IVT injection guidelines in 2004, the most notable of which were a lack of evidence to support the routine use of pre-, peri-, and postinjection antibiotics to reduce the risk of endophthalmitis, and the role of aerosolized droplets containing oral contaminants from the patient and/or providers as a potential source of infection. The panel emphasized the continued importance of applying povidone-iodine to and avoiding eyelid contact with the intended injection site and needle.

CONCLUSION

Updated guidelines on IVT injection technique and monitoring are proposed based on a review of published literature and expert panel deliberations.

摘要

目的

回顾相关证据，并提供玻璃体内（IVT）注射技术及监测的更新指南。

方法

对2004年至2014年发表的关于IVT注射的文献进行回顾，以此作为眼科专家小组圆桌讨论的基础。

结果

IVT注射数量的急剧增加伴随着IVT操作模式和技术相关证据的相应增加。专家小组确定了自2004年最初的IVT注射指南发布以来已经演变的一些领域，其中最显著的是缺乏证据支持常规使用注射前、注射期间和注射后抗生素以降低眼内炎风险，以及含有来自患者和/或医护人员口腔污染物的雾化飞沫作为潜在感染源的作用。该小组强调了在预期注射部位涂抹聚维酮碘并避免眼睑接触注射部位和针头的持续重要性。