Willekens Koen, Reyns Geert, Diricx Marjan, Vanhove Marc, Noppen Bernard, Coudyzer Walter, Ni Yicheng, Feyen Jean H M, Stalmans Peter
Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium.
ThromboGenics NV, Leuven, Belgium.
Invest Ophthalmol Vis Sci. 2017 Mar 1;58(3):1434-1441. doi: 10.1167/iovs.16-20543.
The purpose of this study was to evaluate the dispersion of intravitreally injected solutions and investigate the influence of varying injection techniques.
This was a prospective study using enucleated porcine eyes and ultra-high-resolution computed tomography (UHRCT) scanning to visualize iomeprol intravitreal dispersion. Sixty eyes were divided over 12 different groups according to the injection procedure: fast (2 seconds) or slow (10 seconds) injection speed and needle tip location (6- and 12-mm needle shaft insertion or premacular tip placement verified by indirect ophthalmoscopy). For each of these combinations, eyes were either injected with the combination of V20I (which is an analogue of ocriplasmin) and iomeprol or iomeprol alone. Distance to the macula and volume measurements were performed at 1, 2, 3, and 5 hours after injection.
The measured contrast bolus volume increases slowly over time to an average of 0.70 (P = 0.03), 1.04 (P = 0.006), and 0.79 (P = 0.0001) cm3 5 hours after the injection for the 6-mm needle shaft insertion, 12-mm needle shaft insertion, and premacular needle tip placement, respectively. The distance to the macular marker was significantly lower for premacular needle tip placement injections compared with 6- and 12-mm needle shaft insertion depths.
Ultra-high-resolution computed tomography with three-dimensional reconstruction offers the possibility to study the dispersion of intravitreally injected solutions in a noninvasive manner. Intravitreal premacular solution delivery is possible with an indirect ophthalmoscope-guided injection technique and significantly reduces the time to reach the posterior pole in respect to 6- and 12-mm needle insertion depths. The speed of injection does not influence dispersion significantly.
本研究旨在评估玻璃体内注射溶液的扩散情况，并研究不同注射技术的影响。
这是一项前瞻性研究，使用摘除的猪眼和超高分辨率计算机断层扫描（UHRCT）扫描来观察碘海醇在玻璃体内的扩散。根据注射程序，将60只眼分为12个不同的组：快速（2秒）或缓慢（10秒）注射速度以及针尖位置（针杆插入6毫米和12毫米处或通过间接检眼镜检查确认的黄斑前针尖放置）。对于这些组合中的每一种，眼睛要么注射V20I（一种奥克纤溶酶类似物）和碘海醇的组合，要么仅注射碘海醇。在注射后1、2、3和5小时进行到黄斑的距离测量和体积测量。
对于针杆插入6毫米、12毫米和黄斑前针尖放置，注射后5小时测量的造影剂团块体积随时间缓慢增加，分别平均为0.70（P = 0.03）、1.04（P = 0.006）和0.79（P = 0.0001）cm³。与针杆插入6毫米和12毫米深度相比，黄斑前针尖放置注射到黄斑标记的距离明显更低。
具有三维重建功能的超高分辨率计算机断层扫描提供了以非侵入性方式研究玻璃体内注射溶液扩散的可能性。使用间接检眼镜引导的注射技术可以将溶液递送至黄斑前，相对于针插入6毫米和12毫米深度，显著减少了到达后极的时间。注射速度对扩散没有显著影响。
