Purpose: to evaluate papillary, peripapillary and macular vascular change within 5 minutes from intravitreal injection (IVI) performed in ArcSterile setting. Setting/Venue: Intravitreal Injection Centre of Eye Clinic, Policlinico in Bari, Italy. This diagnostic and surgical setting was a one-way track, from reception, examination, IVI under Arc Sterile and discharge. The presence of instrument in adjacent room allowed us to repeat examination in few minutes after the IVI, when iop spike occurred. Methods: from January 2018 to May 2018, we prospectively selected participants from patients scheduled to perform an IVI. Inclusion criteria were: diagnosis of wet-Age related Macular Degeneration (wAMD) or active myopic Choroidal NeoVascularisation (mCNV). Exclusion criteria were: antiglaucoma treatment or intraocular pressure (IOP) > 21 mmHg, previous intraocular operation other than cataract, significant media opacity, best correct visual acuity (BCVA) < 20/200, poor compliance. All patients underwent to air-puff tonometry, spectral-domain optical coherence tomography (SD-OCT) and SD-OCT Angiography (OCTA), before and immediately after IVI (no later than 5 minutes), because the instruments were placed just outside the room of ArcSterile cabin. Data collected were: age, systemic comorbidity (such as hypertension), use of anticoagulant or antiplatelet, central retinal thickness (CRT), retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) thickness, papillary, peripapillary and macular vessel density (VD) in 3x3 OCTA. Results: 73 patients (78 eyes) were enrolled in the study, 39 male (53.4%) with an average age of 73 ±12 years. Indications for IVI were wAMD (92.3%) and mCNV (7.7%). The drugs administered were ranibizumab (55.1%) and aflibercept (44.9%). After IVI, IOP increased (17.9±2.2 vs 32.6±10.2 mmHg, p<0.01); the superficial vascular plexus vessel density reduced only in parafoveal area with a significantly difference (44.5±5.2 vs 40.8±5.8, p<0.01). Peripapillary fibre layer decreased (100.3±22.2 vs 99.1±21.3, p<0.05). Area and flow area of neovascular membrane unchanged. Conclusions: after the IOP rise caused by IVI, vessel density in SCP and RNFL peripapillary thickness reduced, but neovascular membranes VD, despite their thin wall, did not statistically vary.
Retinal vessel analysis on OCTA immediately after intravitreal injection
Maria Oliva. Grassi
2019-01-01
Abstract
Purpose: to evaluate papillary, peripapillary and macular vascular change within 5 minutes from intravitreal injection (IVI) performed in ArcSterile setting. Setting/Venue: Intravitreal Injection Centre of Eye Clinic, Policlinico in Bari, Italy. This diagnostic and surgical setting was a one-way track, from reception, examination, IVI under Arc Sterile and discharge. The presence of instrument in adjacent room allowed us to repeat examination in few minutes after the IVI, when iop spike occurred. Methods: from January 2018 to May 2018, we prospectively selected participants from patients scheduled to perform an IVI. Inclusion criteria were: diagnosis of wet-Age related Macular Degeneration (wAMD) or active myopic Choroidal NeoVascularisation (mCNV). Exclusion criteria were: antiglaucoma treatment or intraocular pressure (IOP) > 21 mmHg, previous intraocular operation other than cataract, significant media opacity, best correct visual acuity (BCVA) < 20/200, poor compliance. All patients underwent to air-puff tonometry, spectral-domain optical coherence tomography (SD-OCT) and SD-OCT Angiography (OCTA), before and immediately after IVI (no later than 5 minutes), because the instruments were placed just outside the room of ArcSterile cabin. Data collected were: age, systemic comorbidity (such as hypertension), use of anticoagulant or antiplatelet, central retinal thickness (CRT), retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) thickness, papillary, peripapillary and macular vessel density (VD) in 3x3 OCTA. Results: 73 patients (78 eyes) were enrolled in the study, 39 male (53.4%) with an average age of 73 ±12 years. Indications for IVI were wAMD (92.3%) and mCNV (7.7%). The drugs administered were ranibizumab (55.1%) and aflibercept (44.9%). After IVI, IOP increased (17.9±2.2 vs 32.6±10.2 mmHg, p<0.01); the superficial vascular plexus vessel density reduced only in parafoveal area with a significantly difference (44.5±5.2 vs 40.8±5.8, p<0.01). Peripapillary fibre layer decreased (100.3±22.2 vs 99.1±21.3, p<0.05). Area and flow area of neovascular membrane unchanged. Conclusions: after the IOP rise caused by IVI, vessel density in SCP and RNFL peripapillary thickness reduced, but neovascular membranes VD, despite their thin wall, did not statistically vary.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
