Intravitreally Injected Fluid Dispersion: Importance of Injection TechniqueIVI Dispersion

摘要

Purpose:Thepurposeofthisstudywastoevaluatethedispersionofintravitreallyinjectedsolutionsandinvestigatetheinfluenceofvaryinginjectiontechniques.Methods:Thiswasaprospectivestudyusingenucleatedporcineeyesandultra-high-resolutioncomputedtomography(UHRCT)scanningtovisualizeiomeprolintravitrealdispersion.Sixtyeyesweredividedover12differentgroupsaccordingtotheinjectionprocedure:fast(2seconds)orslow(10seconds)injectionspeedandneedletiplocation(6-and12-mmneedleshaftinsertionorpremaculartipplacementverifiedbyindirectophthalmoscopy).Foreachofthesecombinations,eyeswereeitherinjectedwiththecombinationofV20I(whichisananalogueofocriplasmin)andiomeproloriomeprolalone.Distancetothemaculaandvolumemeasurementswereperformedat1,2,3,and5hoursafterinjection.Results:Themeasuredcontrastbolusvolumeincreasesslowlyovertimetoanaverageof0.70(P=0.03),1.04(P=0.006),and0.79(P=0.0001)cm35hoursaftertheinjectionforthe6-mmneedleshaftinsertion,12-mmneedleshaftinsertion,andpremacularneedletipplacement,respectively.Thedistancetothemacularmarkerwassignificantlylowerforpremacularneedletipplacementinjectionscomparedwith6-and12-mmneedleshaftinsertiondepths.Conclusions:Ultra-high-resolutioncomputedtomographywiththree-dimensionalreconstructionoffersthepossibilitytostudythedispersionofintravitreallyinjectedsolutionsinanoninvasivemanner.Intravitrealpremacularsolutiondeliveryispossiblewithanindirectophthalmoscope-guidedinjectiontechniqueandsignificantlyreducesthetimetoreachtheposteriorpoleinrespectto6-and12-mmneedleinsertiondepths.Thespeedofinjectiondoesnotinfluencedispersionsignificantly.