Ultrasound biomicroscopic study of sclerotomy sites after implantation of sustained release drug devices

Vitreous incarceration after ranibizumab injection: an ultrasound biomicroscopy study

BACKGROUND AND OBJECTIVE

The aim of the study was to evaluate vitreous incarceration at the injection site using ultrasound biomicroscopy (UBM) after intravitreal injection of ranibizumab.

PATIENTS AND METHODS

The study included 39 eyes of 34 patients who underwent intravitreal injection of 0.05 mL of ranibizumab. UBM (HiScan; Optikon, Rome, Italy) with a 50 MHz probe was performed 1 day after surgery to determine the existence of vitreous incarceration at the injection site.

RESULTS

The mean patient age was 59.7 (± 10.1) years, and 58.9% were female. Vitreous incarceration into the pars plana site was detected in six eyes (15.3%) the day after intravitreal injection.

CONCLUSION

Vitreous incarceration at the injection site after intravitreal injection is thought to lead to a higher risk for complications such as infection, retinal breaks, retinal detachment, vitreous hemorrhage, and fibrovascular proliferation at the injection site. To understand the clinical importance of vitreous incarceration, further long-term prospective studies are necessary.

Ultrasound biomicroscopy study of vitreous incarceration subsequent to intravitreal injections

OBJECTIVE

To study the existence of vitreous incarceration by ultrasound biomicroscopy (UBM) at the pars plana after direct intravitreal injection of triamcinolone acetonide ± bevacizumab without anterior chamber paracentesis.

DESIGN

Interventional case series.

PARTICIPANTS

Patients undergoing intravitreal injection of triamcinolone acetonide with or without intravitreal bevacizumab.

METHODS

In 21 eyes, the existence of vitreous incarceration at the pars plana site of intravitreal injection of 0.05 mL of drug was studied by UBM (50 MHz probe of the VUmax, Sonomed, NY), the day after surgery, by 1 technician. The reason for injection was diabetic retinopathy in 12 (57.1%) eyes; age-related macular degeneration in 6 (28.6%) eyes; branch retinal vein occlusion in 2 (9.5%) eyes; and choroiditis in 1 eye (4.8%). In 1 eye, only triamcinolone acetonide was injected, and in the other eyes, bevacizumab mixed with triamcinolone acetonide was injected.

RESULTS

We studied 21 eyes in 13 patients. Of the subjects, 61.5% were male. The mean age of the patients was 62.2 years. On the day after intravitreal injection of the drug, vitreous incarceration into the pars plana site was detected by UBM in 42.9% of the eyes.

CONCLUSION

Vitreous incarceration exists after intravitreal injection of drug, but its clinical importance is still unknown. Further long-term prospective studies are recommended.