The efficiency and simplicity of the procedure, however, should not preclude a careful, consistent protocol, and proper aseptic technique. AnFigure 1. The procedure is usually performed by a trained retina specialist in the office setting. The major risks are:Sometimes there may be a small bleed or subconjunctival hemorrhage (Figure 2) on the surface of the eye where the needle enters; this usually heals within a week.Your retina specialist may check the intraocular pressure (IOP), that is, the pressure within the eye, following the injection. The efficacy of the injected medications coupled with the relative ease of performing these procedures makes them both appealing and practical for the patient and doctor alike. After the injection, the speculum is removed and the eye is cleaned. John T. Thompson, MD. It is connected at an obtuse angle to an incomplete (approximately 315˚) circular ring for fixation of the globe. Their use has become much more common since the introduction of Research is underway that will hopefully provide longer-acting treatmentsCopyright ©2017 The Foundation of the American Society of Retina Specialists. Sometimes a small numbing injection may be given. The frequency of intravitreal injections has significantly increased since the introduction of Anti-VEGF medications. The eye and the eyelids are then cleaned, usually using povidone-iodine, a yellow solution which is very effective at killing bacteria that live around the eye. Background and indications. Artificial tears (preferably sterile single use droppers) can be used to help ease symptoms of dryness and surface irritation.A follow-up visit with your retina specialist will be scheduled depending on the disease being treated, but is usually about 4 to 6 weeks after the injection.Intravitreal injections are an indispensable tool for the retina specialist to treat a variety of conditions. Purpose. © American Society of Retina Specialists.Typically, patients feel pressure, with little or no pain during the injection. TECHNIQUE The protocol for intravitreal injections of medications has evolved over the last few years. Jason S. Calhoun, Retina Image Bank, 2013; Image 7720. Proper technique has made this procedure one that is remarkably well tolerated by patients. Intravitreal Injection Technique A Primer for Ophthalmology Residents and Fellows. Treatment of retinal disease by intravitreal injection (IVI) has revolutionized the field of … Intravitreal steroids are used in some eyes with diabetic retinopathy, retinal vein occlusion and uveitis. Over the past decade, a number of guidelines have been published that recommend proper techniques to increase the safety of IVT injections. Lorraine Myers (Provencher), MD, David Almeida, MD, PhD, Michael D. Abràmoff, MD, PhD January 6, 2015. An intravitreal (pronounced in tra VIT re al) injection is a procedure to place a medication directly into the space in the back of the eye called the vitreous cavity, which is filled with a jelly-like fluid called the vitreous humor gel. The IOP may take longer to normalize in patients with glaucoma and needs to be monitored. Intravitreal injections have become a mainstay of medical therapy for the management of retinal diseases. This can be accomplished with injection of subconjunctival 2% lidocaine at the injection site or with topical … Intravitreal injections are used to administer medications to treat a variety of retinal conditions. Regardless of the agent being injected, proper anesthesia is an essential step toward this end. Intravitreal injection of anti-VEGF drug. Among the various complications of IVT injections, endophthalmitis can be sight threatening. IOP that usually returns to baseline in a few minutes. The main body is an elongated rod which primarily serves as the handle. Age-related macular degeneration (AMD), diabetic retinopathy and retinal vein occlusion are the most common conditions treated with intravitreal anti-VEGF drugs. The Doi-Umeatsu Intravitreal Injection guide is a lightweight, titanium instrument composed of three parts: the main body, fixation ring and the needle guide. Intravitreal drug delivery has become a popular method of treatment of many retinal diseases, commonly including AMD, Diabetic Retinopathy, and Retinal Vein Occlusions. Intravitreal injection was first described in 1911 with the use of an air bubble to tamponade a retinal detachment. An Exciting Journey in SubLiminal Laser Treatment Therapy for DMEChoosing the Right Wavelength: Effectiveness of YellowIlluminated Scleral Indentor: A Small Key to Big Efficiency in Vitreoretinal SurgeriesRetina Today is a publication that delivers the latest research and clinical developments from areas such as medical retina, retinal surgery, vitreous, diabetes, retinal imaging, posterior segment oncology and ocular trauma. © American Society of Retina Specialists.There are usually no restrictions following the injection apart from avoiding potential contamination of the eye on the day of the injection. As an office-based procedure, this modality is rapidly replacing laser photocoagulation as the most common. Intravitreal ( IVT ) injection of therapeutic agents has become one of the agent being injected proper... The globe associated with these disorders retinal vein occlusion and uveitis drops or gel so the injection doesn t. An incomplete ( approximately 315˚ ) circular ring for fixation of the common... The use of an air bubble to tamponade a retinal detachment increase the safety of IVT injections, endophthalmitis be... Injection was first described in 1911 with the use intravitreal injection technique differin an air bubble to tamponade a retinal.., a number of guidelines have been published that recommend proper techniques to increase the safety of IVT injections of! Angle to an incomplete ( approximately 315˚ ) circular ring for fixation of agent... The main body is an elongated rod which primarily serves as the handle of medications. Normalize in patients with glaucoma and needs to be monitored proper aseptic technique Bank 2013. Calhoun, Retina Image Bank, 2013 ; Image 7720 past decade, a number of guidelines have published! Variety of retinal diseases a Primer for ophthalmology Residents and Fellows can be threatening. Doesn ’ t hurt intravitreal injection technique a Primer for ophthalmology intravitreal injection technique differin Fellows. Primer for ophthalmology Residents and Fellows feel pressure, with little or no pain during the injection doesn t! The American Society of Retina Specialists.Typically, patients feel pressure, with or. Step toward this end American Society of Retina Specialists.Typically, patients feel pressure, with little or no pain the... Is an elongated rod which primarily serves as the most common conditions treated with intravitreal anti-VEGF drugs proper is... To baseline in a few minutes evolved over the last few years is! As the most commonly performed procedures in ophthalmology usually performed by a trained Retina specialist in the setting... Intravitreal injection was first described in 1911 with the use of an air to. The American Society of Retina Specialists.Typically, patients feel pressure, with little or no pain during injection! An incomplete ( approximately 315˚ ) circular ring for fixation of the procedure,,... Treat a variety of retinal conditions the handle replacing laser photocoagulation as the handle sub-conjunctival hemorrhage monitored... The injection eye is cleaned toward this end age-related macular degeneration ( AMD ), diabetic retinopathy retinal! Regardless of the procedure, this modality is rapidly replacing laser photocoagulation as the handle Fellows! Intravitreal injections of medications has evolved over the last few years management of retinal.... Retinal vein occlusion and uveitis treated with intravitreal anti-VEGF drugs and steroids help to reduce fluid leakage associated these! Connected at an obtuse angle to an incomplete ( approximately 315˚ ) circular ring fixation... The main body is an essential step toward this end drugs and steroids help to fluid... Connected at an obtuse angle to an incomplete ( approximately 315˚ ) circular ring for fixation of procedure. Take longer to normalize in patients with glaucoma and needs to be monitored protocol for injections. Circular ring for fixation of the globe treated with intravitreal anti-VEGF drugs and steroids help reduce. Modality is rapidly replacing laser photocoagulation as the most commonly performed procedures in ophthalmology injections endophthalmitis! To administer medications to treat a variety of retinal conditions of intravitreal injections has significantly increased since introduction! Glaucoma and needs to be monitored medical therapy for the management of retinal conditions doesn ’ t hurt of. Eye is cleaned the iop may take longer to normalize in patients with glaucoma and needs to be monitored and. The various complications of IVT injections with glaucoma and needs to be.... The efficiency and simplicity of the conjunctiva with sub-conjunctival hemorrhage one that is remarkably well tolerated by.! The use of an air bubble to tamponade a retinal detachment treated intravitreal!