Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
Surv Ophthalmol. 2024 Sep-Oct;69(5):722-732. doi: 10.1016/j.survophthal.2024.05.004. Epub 2024 May 24.
Subretinal injection is the preferred delivery technique for various novel ocular therapies and is widely used because of its precision and efficient delivery of gene and cell therapies; however, choosing an injection point and defining delivery parameters to target a specified retinal location and area is an inexact science. We provide an overview of the key factors that play important roles during subretinal injections to refine the technique, enhance patient outcomes, and minimise risks. We describe the role of anatomical and physical variables that affect subretinal bleb propagation and shape and their impact on retinal integrity. We highlight the risks associated with subretinal injections and consider strategies to mitigate reflux and retinal trauma. Finally, we explore the emerging field of robotic assistance in improving intraocular manouvrability and precision to facilitate the injection procedure.
视网膜下注射是各种新型眼科治疗的首选给药技术，由于其精确性和高效性，基因和细胞治疗的给药，因此被广泛应用；然而，选择注射点并定义给药参数以靶向特定的视网膜位置和区域是一门不精确的科学。我们提供了在视网膜下注射中起重要作用的关键因素概述，以完善该技术，提高患者的治疗效果，并将风险最小化。我们描述了影响视网膜下气泡传播和形状的解剖和物理变量的作用，以及它们对视网膜完整性的影响。我们强调了与视网膜下注射相关的风险，并考虑了减轻反流和视网膜创伤的策略。最后，我们探讨了机器人辅助在改善眼内可操作性和精确性以促进注射过程中的新兴领域。
