Survey: technique of performing intravitreal injection among members of the Brazilian Retina and Vitreous Society (SBRV)

Purpose: To evaluate and describe the precautions involved in the technique of intravitreal injection of antiangiogenic drugs adopted by the ophthalmologists who are members of the Brazilian Society of Retina and Vitreous (SBRV). Methods: A questionnaire containing 22 questions related to precautions taken before, during, and after intravitreal injection was sent electronically to 920 members of SBRV between November 15, 2013 and April 31, 2014. Results: 352 responses (38%) were obtained. There was a predominance of men (76%) from the southwest region of Brazil (51%). The professional experience varied between 6 and 15 years after medical specialization (50%). Most professionals (76%) performed an average of 1 to 10 intravitreal injections a week, and 88% of the procedures were performed in the operating room using povidone iodine (99%), sterile gloves, and blepharostat (94%). For inducing topical anesthesia, usage of anesthetic eye drops was the most used technique (65%). Ranibizumab (Lucentis®) was the most common drug (55%), and age-related macular degeneration (AMD) was the most treated disease (57%). Regarding the complications treated, 6% of the ophthalmologists had treated at least one case of retinal detachment, 20% had treated cases of endophthalmitis, 9% had treated cases of vitreous hemorrhage, and 12% had encountered cases of crystalline lens touch. Conclusion: Intravitreal injection is a procedure routinely performed by retina specialists and has a low incidence of complications. Performing the procedure in the operating room using an aseptic technique was preferred by most of the respondents. Ranibizumab was the most used drug, and AMD was the most treated disease.

研究目的：评估并描述巴西视网膜玻璃体学会（Brazilian Society of Retina and Vitreous, SBRV）会员眼科医师所采用的抗血管生成药物玻璃体内注射（intravitreal injection）技术相关的注意事项。
研究方法：于2013年11月15日至2014年4月31日期间，通过电子问卷形式向920名SBRV会员发放包含22个与玻璃体内注射术前、术中、术后注意事项相关的问题的调研问卷。
研究结果：本次调研共回收有效问卷352份，回收率为38%。受访者以男性为主（占比76%），多来自巴西西南部地区（占比51%）。从业经验方面，50%的受访者在医学专科毕业后拥有6至15年的临床工作经验。多数受访医师（76%）每周平均开展1至10次玻璃体内注射操作，其中88%的操作在手术室完成，操作过程中99%使用聚维酮碘、无菌手套，94%使用眼睑拉钩。局部麻醉诱导最常用的方式为滴用麻醉滴眼液（占比65%）。最常用的治疗药物为雷珠单抗（Ranibizumab，商品名Lucentis®，占比55%），最常见的治疗疾病为年龄相关性黄斑变性（age-related macular degeneration, AMD，占比57%）。在并发症相关情况中，6%的眼科医师曾接诊至少1例视网膜脱离病例，20%曾接诊眼内炎病例，9%曾接诊玻璃体积血病例，12%曾遇到晶状体接触病例。
研究结论：玻璃体内注射是视网膜专科医师常规开展的诊疗操作，并发症发生率较低。多数受访者偏好于在手术室采用无菌技术开展该操作。雷珠单抗为最常用的治疗药物，年龄相关性黄斑变性为最常见的治疗疾病。