Intravitreal infusion: A novel approach for intraocular drug delivery.

Jiao Tian,Xiao Liu,Jia Liu,Luosheng Tang,Yangyan Xiao

doi:10.1038/srep37676

Abstract

Intraocular injection has become an increasingly important intervention in the treatment of posterior segment diseases. However, an acute intraocular pressure (IOP) elevation after intravitreal injection is a common concern. This study aimed to evaluate the efficacy of intravitreal infusion in maintaining stable IOP in a rabbit model. Trypan blue (TB) 0.06% with an external pump was used to evaluate intravitreal infusion in rabbit eyes. Groups A (50 μL), B (100 μL), C (150 μL), and D (200 μL) were slowly infused over 30 minutes with TB. As a control, Group E underwent conventional intravitreal injection of 100 μL of TB. Group F received a bolus infusion of 100 μL of TB within 1 minute. The mean increases in IOP during infusion for each group were: Group A (7.93 ± 3.80 mmHg), B (13.97 ± 3.17 mmHg), C (19.91 ± 6.06 mmHg) and D (29.38 ± 8.97 mmHg). Immediately post-injection in group E the mean increase in IOP amounted to 34.33 ± 6.57 mmHg. The mean increase in IOP of group F after bolus infusion was 49.89 ± 1.71 mmHg. Intravitreal infusion maintains a stable IOP and provides a controlled infusion speed compared with intravitreal injection.

Highlights

Intravitreal injection is the currently accepted method to treat posterior segment diseases, such as age-related macular degeneration (AMD), diabetic retinopathy, vascular occlusions, cystoid macular edema, uveitis, viral retinitis, endopthalmitis, and retinal detachment[1,2,3]
Rabbits were fitted with insulin pumps that were used as intravitreal infusion devices
Group E received a bolus injection of 100 μL of Trypan blue (TB), similar to the clinical procedure performed in humans

Summary

Introduction

Intravitreal injection is the currently accepted method to treat posterior segment diseases, such as age-related macular degeneration (AMD), diabetic retinopathy, vascular occlusions, cystoid macular edema, uveitis, viral retinitis, endopthalmitis, and retinal detachment[1,2,3]. This procedure allows a direct application of the drug into the posterior eye, eliminating the barriers that are common with topical and systemic administration. The eye is a closed system and is sensitive to an increase of even small volumes of solution It is characterized by IOP elevation and/or drug and vitreous reflux after intravitreal injection. There are other complications with anterior chamber paracentesis, including lens damage, hyphema, patient discomfort and infection

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Conclusion