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Updated: Apr 19, 2026

Intravitreous Injection for Establishing Ocular Diseases Model
Published on: October 1, 2007
Intravitreal injection technique and monitoring: updated guidelines of an expert panel
Robert L Avery1, Sophie J Bakri, Mark S Blumenkranz
1*California Retina Consultants and Research Foundation, Santa Barbara, California; †Mayo Clinic, Rochester, Minnesota; ‡Byers Eye Institute, Stanford University School of Medicine, Stanford, California; §Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; ¶California Pacific Medical Center, San Francisco, California; **The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California; ††West Coast Retina, San Francisco, California; ‡‡Weill Cornell Medical College, New York-Presbyterian Medical Center, New York, New York; §§Keck School of Medicine, University of Southern California, Los Angeles, California; ¶¶Bascom Palmer Eye Institute, University of Miami, Miami, Florida; ***Vitreous-Retina-Macula Consultants of New York, New York; †††Wills Eye Hospital, Philadelphia, Pennsylvania; ‡‡‡Manhattan Eye, Ear & Throat Hospital, New York University Medical Center, New York, New York; §§§Jules Stein Eye Institute, University of California, Los Angeles, California; ¶¶¶University of Illinois, Chicago, Illinois; ****Stanford University School of Medicine, Stanford, California; and ††††Oakland University William Beaumont School of Medicine, Beaumont Eye Institute, Royal Oak, Michigan.
Purpose:
To review evidence and provide updated guidelines on intravitreal (IVT) injection technique and monitoring.
Methods:
A review of the published literature on IVT injection from 2004 to 2014 formed the basis for round table deliberations by an expert panel of ophthalmologists.
Results:
The dramatic increase in the number of IVT injections has been accompanied by a comparable increase in evidence surrounding IVT practice patterns and techniques. The expert panel identified a number of areas that have evolved since publication of the original IVT injection guidelines in 2004, the most notable of which were a lack of evidence to support the routine use of pre-, peri-, and postinjection antibiotics to reduce the risk of endophthalmitis, and the role of aerosolized droplets containing oral contaminants from the patient and/or providers as a potential source of infection. The panel emphasized the continued importance of applying povidone-iodine to and avoiding eyelid contact with the intended injection site and needle.
Conclusion:
Updated guidelines on IVT injection technique and monitoring are proposed based on a review of published literature and expert panel deliberations.
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