Sivertsen Magne Sand, Lode Heidrun Elisabeth, Gjølberg Torleif Tollefsrud, Petrovski Goran, Andersen Jan Terje, Jørstad Øystein Kalsnes, Moe Morten Carstens
Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.
Department of Immunology, Oslo University Hospital, Oslo, Norway.
BMJ Open Ophthalmol. 2021 Aug 19;6(1):e000764. doi: 10.1136/bmjophth-2021-000764. eCollection 2021.
To describe a cluster of symptomatic intravitreal silicone oil (SiO) droplets following intravitreal injections (IVIs) and assess the effect of switching to a SiO-free syringe.
Observational quality registry study of patients receiving IVI at a large Norwegian ophthalmology centre between April 2018 (start of cluster) and November 2019 (1 year after switching to SiO-free syringes). At onset, anti-vascular endothelial growth factor drugs were administered using SiO-containing insulin syringes. From November 2018, SiO-free syringes were implemented. Spontaneously reported symptomatic SiO cases were confirmed by slit-lamp examination. A follow-up interview was performed after 1 year, assessing visual complaints. The prevalence of non-symptomatic cases was assessed in a sample of 50 eyes from 50 consecutive IVI patients.
Among 13 429 IVIs, 50 eyes of 46 patients (29 women) with symptomatic intravitreal SiO droplets were identified. Forty-one patients reported floaters at regular appointments, whereas five patients contacted the department regarding symptoms between scheduled appointments. After 1 year, 34 patients (79%) still experienced floaters, 21 (49%) reported reduced symptoms and 3 (7%) reported worsened symptoms. Eighteen patients (42%) reported being bothered, and eight (18.6%) reported that their lives were negatively affected by the floaters. Among 50 non-symptomatic eyes that had received IVI during the same period, intravitreal SiO was found in 34 (68%). No cases of symptomatic intravitreal SiO droplets were identified after switching to SiO-free syringes.
Symptomatic intravitreal SiO following IVI can cause significant and prolonged distress for affected patients. It can be avoided by using SiO-free syringes.
描述玻璃体内注射（IVI）后出现的一组有症状的玻璃体内硅油（SiO）滴，并评估改用不含SiO的注射器的效果。
对2018年4月（该组开始）至2019年11月（改用不含SiO的注射器1年后）在挪威一家大型眼科中心接受IVI的患者进行观察性质量登记研究。开始时，使用含SiO的胰岛素注射器给予抗血管内皮生长因子药物。从2018年11月起，开始使用不含SiO的注射器。通过裂隙灯检查确诊自发报告的有症状的SiO病例。1年后进行随访访谈，评估视觉方面的不适。在连续50例接受IVI的患者的50只眼中抽取样本，评估无症状病例的患病率。
在13429次IVI中，确定了46例患者（29名女性）的50只眼中出现有症状的玻璃体内SiO滴。41例患者在定期就诊时报告有飞蚊症，而5例患者在预定就诊时间之间因症状联系了该科室。1年后，34例患者（79%）仍有飞蚊症，21例（49%）报告症状减轻，3例（7%）报告症状加重。18例患者（42%）报告受到困扰，8例（18.6%）报告飞蚊症对他们的生活产生了负面影响。在同期接受IVI的50只无症状眼中，34只（68%）发现有玻璃体内SiO。改用不含SiO的注射器后，未发现有症状的玻璃体内SiO滴病例。
IVI后出现的有症状的玻璃体内SiO可给受影响的患者带来严重且持久的困扰。使用不含SiO的注射器可避免这种情况。
