Agbahoungba L, Alamou S, Abouki C, Djossou-Doutetien A, Lawani R, Tchabi S
Clinique Ophtalmologique la Lumière, Cotonou, Bénin; Centre d'Exploration de la Rétine, Cotonou, Bénin.
Centre National Hospitalier Universitaire Hubert Koutoukou Maga, Cotonou, Bénin.
J Fr Ophtalmol. 2018 Dec;41(10):963-967. doi: 10.1016/j.jfo.2018.02.027. Epub 2018 Nov 22.
Intravitreal injections of medication are designed to obtain a high concentration in the posterior segment. We conducted a retrospective study of our practice of intravitreal injections to assess safety of the technique and short- and medium-term tolerability, and to analyze indications and the complications.
This analytic retrospective study focused on consecutive patients treated with intravitreal injections for the period of January 2015 to June 2016 in the "Lumière" ohthalmology clinic in Cotonou, with incidents or accidents during the injection procedure as a measure of safety. Included were all patients undergoing one or more intravitreal injections regardless of the type of product injected, who had undergone a complete ophthalmologic work-up prior to injection and who had been followed at one week (W1) and 1 month (M1) after treatment.
During the study period, we safely performed 124 intravitreal injections on 49 patients. The indications were diabetic macular edema in 53.06% and macular edema due to vein occlusions in 26.53%. The main complication observed was ocular hypertension in 60%, mainly related to triamcinolone injection. In 51.02%, the drug used was Ranibizumab, followed by Bevacizumab in 28.54% and Triamcinolone in 20.40%.
The main goal of intravitreal injection is to achieve instantly effective concentrations in the center of the globe. Intravitreal injection is a safe, feasible practice in our context. The male predominance observed in our series is explained by the low socio-economic status of women in our context as well as the economically difficult accessibility of important drugs such as anti-VEGF. Significant improvements in D7 and D30 visual acuity in our patients highlights the beneficial effects of the presence of the active molecule in the vitreous cavity for these indications.
Intravitreal injection is a common practice in our context, which is being performed safely. The indications are many, and ocular hypertension is a significant complication. The difficulties in terms of supply and preservation of the main drugs used (anti-VEGF) remains to be resolved.
玻璃体内注射药物旨在使眼后段达到高浓度。我们对玻璃体内注射操作进行了一项回顾性研究，以评估该技术的安全性、短期和中期耐受性，并分析其适应证及并发症。
这项分析性回顾性研究聚焦于2015年1月至2016年6月在科托努“卢米埃尔”眼科诊所接受玻璃体内注射治疗的连续患者，将注射过程中的事件或意外作为安全性衡量指标。纳入所有接受过一次或多次玻璃体内注射的患者，无论所注射产品类型如何，这些患者在注射前均接受了全面的眼科检查，并在治疗后1周（W1）和1个月（M1）进行了随访。
在研究期间，我们对49例患者安全地进行了124次玻璃体内注射。适应证方面，糖尿病性黄斑水肿占53.06%，静脉阻塞所致黄斑水肿占26.53%。观察到的主要并发症是眼压升高，占60%，主要与曲安奈德注射有关。在51.02%的病例中使用的药物是雷珠单抗，其次是贝伐单抗，占28.54%，曲安奈德占20.40%。
玻璃体内注射的主要目标是在眼球中心立即达到有效浓度。在我们的环境中，玻璃体内注射是一种安全、可行的操作。我们系列研究中观察到男性占优势，这是由于我们环境中女性社会经济地位较低以及抗VEGF等重要药物在经济上难以获得。我们患者在第7天和第30天视力有显著改善，突出了玻璃体内腔中活性分子对这些适应证的有益作用。
在我们的环境中，玻璃体内注射是一种常见操作，且操作安全。适应证众多，眼压升高是一个重要并发症。主要使用药物（抗VEGF）在供应和保存方面的困难仍有待解决。
