Oblique (Angled) Injection Technique Improves the Delivery of Avastin Treatment
Byline: Published in the European Journal of Ophthalmology, 2015;25:173-6.
Intravitreal (IVT) injections are the most common surgical procedure in ophthalmology today. In fact, it is projected that millions of these injections are given each year in the United States. Ocular oncologists use intravitreal injections to treat such conditions as cystoid macular edema (CME), radiation retinopathy, and neovascularization. But did you know that the technique of delivering the injection can influence the effectiveness and safety of treatment?
Following IVT injection, some medication can actually egress or leave the eye through the injection site, thus losing the medication the physician intended. This can lead to under-treatment of the disease. The perfect IVT injection delivers an exact amount of medication with the least risk to vision and the eye.
Mehta and Finger described a technique of oblique (or angled) IVT injection in an effort to minimize the amount of medication leaving the eye. IVT injection was delivered at a 45 degree angle and compared to the standard technique of using a perpendicular (orthogonal) angle.
The researchers found that the angled IVT injection technique was relatively self-sealing. This finding suggests that angled injections keep more of the drug in the eye, delivers a more accurate dose and prevents intraocular infection by closing a potential entry for pathogens.
The figure above shows how the angled technique may allow for better retention of the drug within the eye following injection.
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