[Intravitreal injections: Guidelines, methods and medicolegal issues]

Area of Science:

• Ophthalmology
• Retinal Diseases
• Pharmacology

Background:

• Intravitreal injection (IVI) is a key method for delivering drugs directly into the eye, achieving higher intraocular concentrations than systemic administration.
• The prevalence of vitreoretinal diseases and the use of vascular endothelial growth factor (VEGF) antagonists have significantly increased the demand for IVI procedures.
• Despite its proven safety, IVI carries a small but significant risk of endophthalmitis, a severe intraocular infection.

Purpose of the Study:

• To detail current recommendations for aseptic and antiseptic techniques during intravitreal injections.
• To propose a standardized procedural sequence for performing intravitreal injections.
• To address the challenges associated with the increasing volume of IVI procedures.

Main Methods:

• Review of current clinical guidelines and best practices for aseptic techniques in ophthalmology.
• Description of a step-by-step protocol for performing intravitreal injections.
• Analysis of the incidence and risk factors for endophthalmitis following IVI.

Main Results:

• Established protocols emphasize stringent aseptic and antiseptic measures to mitigate infection risk.
• A detailed procedural sequence for IVI is presented to ensure consistency and safety.
• The risk of endophthalmitis following IVI is quantified at approximately 0.05%.

Conclusions:

• Adherence to rigorous aseptic techniques is paramount for safe intravitreal injections.
• Standardized procedures can help minimize complications such as endophthalmitis.
• The increasing utilization of IVI necessitates continuous evaluation and optimization of protocols.