Kishore Kamal, McGowan Daniel S, Hanebrink Kurt A
Illinois Retina and Eye Associates, Peoria, Illinois, USA.
Department of Surgery, University of Illinois College of Medicine, Peoria, Illinois, USA.
Case Rep Ophthalmol. 2021 Apr 12;12(1):248-253. doi: 10.1159/000512695. eCollection 2021 Jan-Apr.
We present 2 cases of iatrogenic retinal penetration from intravitreal (IVT) injections in a retrospective noncomparative case series of 2 patients. The first patient, an 81-year-old Caucasian male, developed dense vitreous hemorrhage soon after receiving an IVT bevacizumab injection for macular edema from central retinal vein occlusion. A 25-g vitrectomy 1 week later showed a retinal hole surrounded by fresh hemorrhages in the same quadrant as the IVT injection. The second patient, an 87-years-old male, developed a retinal detachment after 28 injections of anti-VEGF medications for neovascular AMD. A peripheral round hole was observed during vitrectomy without any lattice degeneration in the same quadrant as prior IVT injections. Both eyes were pseudophakic, had normal axial lengths, and received injections without measuring the injection site. Retinal penetration from IVT injections can result in serious sight-threatening complications. Measuring the injection site from the limbus should be part of safe IVT injection technique.
在一项对2例患者的回顾性非对照病例系列研究中，我们报告了2例因玻璃体内（IVT）注射导致医源性视网膜穿孔的病例。首例患者为一名81岁的白种男性，因视网膜中央静脉阻塞所致黄斑水肿接受IVT贝伐单抗注射后不久，发生了严重的玻璃体积血。1周后进行的25G玻璃体切除术显示，在与IVT注射相同象限出现了一个被新鲜出血包围的视网膜裂孔。第二例患者为一名87岁男性，在为新生血管性AMD进行28次抗VEGF药物注射后发生了视网膜脱离。玻璃体切除术中在与先前IVT注射相同象限观察到一个周边圆孔，且无任何格子样变性。双眼均为人工晶状体眼，眼轴长度正常，注射时未测量注射部位。IVT注射导致的视网膜穿孔可引起严重的视力威胁性并发症。从角膜缘测量注射部位应成为安全IVT注射技术的一部分。
