[1]邵毅.玻璃体内注射技术规范——2018年欧洲视网膜专家学会共识解读[J].眼科新进展,2018,38(12):1101-1104.[doi:10.13389/j.cnki.rao.2018.0260]
　SHAO Yi.Consensus interpretation on the specification of vitreous injection technology by the European society of retinal experts in 2018[J].Recent Advances in Ophthalmology,2018,38(12):1101-1104.[doi:10.13389/j.cnki.rao.2018.0260]
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玻璃体内注射技术规范——2018年欧洲视网膜专家学会共识解读/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
38卷
期数:
2018年12期
页码:
1101-1104
栏目:
述评
出版日期:
2018-12-05

文章信息/Info

Title:
Consensus interpretation on the specification of vitreous injection technology by the European society of retinal experts in 2018
作者:
邵毅
330006　江西省南昌市，南昌大学第一附属医院眼科
Author(s):
SHAO Yi
Department of Ophthalmology，the First Affiliated Hospital of Nanchang,Nanchang 330006,Jiangxi Province China
关键词:
玻璃体内注射; 专家共识; 解读
Keywords:
intravitreal injection; specialist consensus; interpretation
分类号:
R77
DOI:
10.13389/j.cnki.rao.2018.0260
文献标志码:
A
摘要:
玻璃体内注射（intravitreal injections，IVI）已成为眼科最常用的治疗手段之一，能够提高许多药物在眼部治疗的效果，减少全身不良反应，是目前最有效的治疗各种视网膜和脉络膜疾病的方法。为了IVI规范化管理操作及提高安全性，欧洲视网膜专家学会于2018年发布了规范化IVI技术共识。本文将对此共识进行解读，以帮助我国眼科医生提高对此技术的理解，减少不良反应。
Abstract:
Intravitreal injection （IVI） has become one of the most commonly used treatment methods in ophthalmology，which can improve the effect of many drugs in the eye treatment and reduce the adverse reactions of the whole body.In order to standardize the management of IVI operations and improve security，the European academy of retinal experts issued the consensus on standardized vitreous injection technology in 2018，which will be interpreted in this paper to help Chinese oculists improve their understanding of this technology and reduce adverse reactions.

参考文献/References:

［1］　OHM J.ber die behandlung der netzhautablsung durch operative entleerung der subretinalen flüssigkeit und einspritzung von luft in den glaskrper［J］.Albrecht Von Graefes Arch Für Ophthalmol，1911，79（3）：442-450.
［2］　HENRY K，CANTRILL H，FLETCHER C，CHINNOCK B J，BALFOUR H H.Use of intravitreal ganciclovir （dihydroxy propoxymethyl guanine） for cytomegalovirus retinitis in a patient with AIDS［J］.Am J Ophthalmol，1987，103（1）：17-23.
［3］　AIELLO L P，BRUCKER A J，CHANG S，CUNNINGHAM E T，D’AMICO D J，FLYNN H W，et al.Evolving guidelines for intravitreous injections［J］.Retina，2004，24（5 Suppl）：S3-S19.
［4］　WILLIAMAS G A.Review of ophthalmology：IVT injections：health policy implications［EB/OL］.http：//www.reviewofophthalmology.com/content/d/retinal_insider/c/48732.
［5］　LANZETTA P，HOLZ F，MONES J，QUERQUES G，STANGA P，VERITTI D，et al.Intravitreal injections：a healthcare failure modes and effects analysis［J］.Ophthalmologica，2013，230（3）：151-164.
［6］　CONCILLADO M，LUND-ANDERSEN H，MATHIESEN E R，LARS-EN M.Dexamethasone intravitreal implant for diabetic macular edema during pregnancy［J］.Am J Ophthalmol，2016，165（1）：7-15.
［7］　AVERY R L，CASTELLARIN A A，STEINLE N C，DHOOT D S，PIERAMICI D J，SEE R，et al.Systemic pharmacokinetics following intravitreal injections of ranibizumab，bevacizumab or aflibercept in patients with neovascular AMD［J］.Br J Ophthalmol，2014，98（12）：1636-1641.
［8］　MOON S W，OH J，YU H G，CHO H Y，SONG S J.Incidence and risk factors for macular hemorrhage following intravitreal ranibizumab injection for neovascular age-related macular degeneration［J］.J Ocul Pharmacol Ther，2013，29（6）：556-559.
［9］　LYALL DA，TEY A，FOOT B，ROXBUGRH S T，VIRDI M，ROBERTSON C，et al.Post-intravitreal anti-VEGF endophthalmitis in the United Kingdom：incidence，features，risk factors，and outcomes［J］.Eye （Lond），2012，26（12）：1517-1526.
［10］　LIN X，DORREPAAL S J，GALE J.Survey of intravitreal injection techniques and treatment protocols among retina specialists in Canada［J］.Can J Ophthalmol，2014，49（3）：261-266.
［11］　GARG S J，DOLLIN M，HSU J.Effect of a strict ’no-talking’ policy during intravitreal injection on post-injection endophthalmitis［J］.Osli Retina，2015，46（10）：1028.
［12］　WEN J C，MCCANNEL C A，MOCHON A B，GARNER O B.Bacterial dispersal associated with speech in the setting of intravitreous injections［J］.Arch Ophthalmol，2011，129（12）：1551-1554.
［13］　PULIDO J S，PULIDO C M，BAKRI S J，MCCANNEL C A，CAMERON J D.The use of 31-gauge needles and syringes for intraocular injections［J］.Eye （Lond），2007，21（6）：829-830.
［14］　DE STEFANO V S，ABECHAIN J J，DE ALMEIDA L F，VERGINASSI D M，RODRIGUES E B，FREYMULLER E.Experimental investigation of needles，syringes and techniques for intravitreal injections［J］.Clin Exp Ophthalmol，2011，39（3）：236-242.
［15］　HUBSCHMAN J P，COFFEE R E，BOURGE J L，YU F，SCHWARTZ S D.Experimental model of intravitreal injection techniques［J］.Retina，2010，30（1）：167-173.
［16］　TUFAN H A，VURAL A，GENCER B，KARA S，ARIKAN S，YUKAEL E.Bacterial contamination of needles used for intravitreal injections：comparison between 27-gauge and 30-gauge needles［J］.Ocul Immunol Inflamm，2013，21（5）：366-370.
［17］　BHAVSAR A R，GOOGE J M J，STOCKDALE C R，BRESSLER N M，BRUCKER A J，ELMAN M，et al.Risk of endophthalmitis after intravitreal drug injection when topical antibiotics are not required：the diabetic retinopathy clinical research network laser-ranibizumab-triamcinolone clinical trials［J］.Arch Ophthalmol，2009，127（12）：1581-1583.
［18］　MAYER C H，FUNG A，SAXENA S，HOLZ F G.Retinal physician：steps for a safe intravitreal injection technique，2009［EB/OL］.http：//www.retinalphysician.com/articleviewer.aspx?articleid=103195.
［19］　SPEKER M G，MILCH F A，SHAH M K，EISNER W，KREISWIRTH B N.Role of external bacterial flora in the pathogenesis of acute postoperative endophthalmitis［J］.Ophthalmology，1991，98（5）：639-649.
［20］　BERKELMAN R L，HOLLAND B W，ANDERSON R L.Increased bactericidal activity of dilute preparations of povidone-iodine solutions［J］.J Clin Microbiol，1982，15（4）：635-639.
［21］　WHITACRE M M，CROCKETT R S.Tolerance of intravitreal povidone-iodine in rabbit eyes［J］.Curr Eye Res，1990，9（8）：725-732.
［22］　FERGUSON A W，SCOTT J A，MCGAVIGAN J，ELTON R A，MCLEAN J，SCHMIDT U，et al.Comparison of 5% povidone-iodine solution against 1% povidone-iodine solution in preoperative cataract surgery antisepsis：a prospective randomised double blind study［J］.Br J Ophthalmol，2003，87（2）：163-167.
［23］　STRANZ C V，FRAENKEL G E，BUTCHER A R，ESTERMAN A J，GOGGIN M J.Survival of bacteria on the ocular surface following double application of povidone-iodine before cataract surgery［J］.Eye（Lond），2011，25（11）：1423-1428.
［24］　HAMILL M B，OSATO M S，WILHELMUS K R.Experimental evaluation of chlorhexidine gluconate for ocular antisepsis［J］.Antimicrob Agents Chemother，1984，26（6）：793-796.
［25］　YORSTON D.Intravitreal injection technique［J］.Community Eye Health，2014，27（87）：47.
［26］　MANSOUR A M，SHAHIN M，KOFOED P K，PARODI M B，SHAMI M，SCHWARTZ S G.Insight into 144 patients with ocular vascular events during VEGF antagonist injections［J］.Clin Ophthalmol，2012，6：343-363.
［27］　GRAGOUDAS E S，ADAMIS A P，CUNNINGHAM E T，FEINSOD M，GUYER D R；VEGF inhibition study in ocular neovascularization clinical trial group.Pegaptanib for neovascular age-related macular degeneration［J］.N Engl J Med，2004，351（27）：2805-2816.
［28］　BHAVSAR A R，GOOGE J R，STOCKDALE C R，BRESSLER N M，BRUCKER A J，ELMAN M，et al.Risk of endophthalmitis after intravitreal drug injection when topical antibiotics are not required：the diabetic retinopathy clinical research network laser-ranibizumab-triamcinolone clinical trials［J］.Arch Ophthalmol，2009，127（12）：1581-1583.
［29］　GREEN-SIMMS A E，EKDAWI N S，BAKRI S J.Survey of intravitreal injection techniques among retinal specialists in the United States［J］.Am J Ophthalmol，2011，151（2）：329-332.
［30］　AVERY R L，BAKRI S J，BLUMENKRANZ M S，BRUCKER A J，CUNNINGHAM E T，D’Amico D J，et al.Intravitreal injection technique and monitoring：updated guidelines of an expert panel［J］.Retina，2014，34：S1-S18.
［31］　SCHWARTZ S G，FLYNN H W，GRZYBOWSKI A.Controversies in topical antibiotics use with intravitreal injections［J］.Curr Pharm Design，2015，21（32）：4703-4706.
［32］　FALAVARJANI K G，MODARRES M，HASHEMI M，PARVAR-ESH M M，NASERIPOUR M，ZARE-MOGHADDAM A，et al.Incidence of acute endophthalmitis after intravitreal bevacizumab injection in a single clinical center［J］.Retina，2013，33（5）：971-974.
［33］　RICCA A M，MORSHEDI R G，WIROSTKO B M.High intra-ocular pressure following anti-vascular endothelial growth factor therapy：proposed pathophysiology due to altered nitric oxide metabolism［J］.J Ocul Pharmacol Ther，2015，31（1）：2-10.
［34］　ALAGZ N，ALAGZ C，YILMAZ I，YILDIRIM Y，BAZ ，ALTAN ，et al.Immediate intraocular pressure changes following intravitreal dexamethasone implant［J］.J Ocul Pharmacol Ther，2016，32（1）：44-49.
［35］　YANNUZZI N A，PATEL S N，BHAVSAR K V，SUGIGUCHI F，FREUND K B.Predictors of sustained intraocular ressure elevation in eyes receiving intravitreal anti-vascular endothelial growth factor therapy［J］.Am J Ophthalmol，2014，158（2）：319-327.
［36］　AREF A A，SCOTT I U，ODEN N L，IP M S，BLODI B A，VAN VELDHUISEN P C.Incidence，risk factors，and timing of elevated intraocular pressure after intravitreal triamcinolone acetonide injection for macular edema secondary to retinal vein occlusion：SCORE study report 15［J］.JAMA Ophthalmol，2015，133（9）：1022-1029.
［37］　MATURI R K，POLLACK A，UY H S，VARANO M，GOMES A M，LI X Y，et al.Ozurdex MEAD Study Group：Intraocular pressure in patients with diabetic macular edema treated with dexamethasone intravitreal implant in the 3-year MEAD study［J］.Retina，2016，36（6）：1143-1152.
［38］　LEMOS V，CABUGUEIRA A，NORONHA M，ABEGAO PINTO L，REINA M，BRANCO J，et al.Intraocular pressure in eyes receiving intravitreal antivascular endothelial growth factor injections［J］.Ophthalmologica，2015，233（3-4）：162-168.
［39］　HOLLANDS H，WONG J，BRUEN R，CAMPBELL R J，SHARMA S，GALE J，et al.Short-term intraocular pressure changes after intravitreal injection of bevacizumab［J］.Can J Ophthalmol，2007，42（6）：807-811.

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备注/Memo

备注/Memo:
国家自然科学基金资助（编号：81160118、81460092、81400372、81660158）；江西省远航工程（编号：2014022）；江西省自然科学基金重大项目（编号：2016-ACB21017）；江西省自然科学基金重大项目（编号：20151BAB2150-16）；江西省重点研发项目（编号：20151BBG70223、20181BBG70004）；江西省教育厅重点项目（编号：GJJ160020）
更新日期/Last Update: 2018-12-04