Oblique (Angled) Injection Technique Improves the Delivery of Avastin Treatment

Intravitreal (IVT) injections are the most common surgical procedure in ophthalmology practice today. In fact, it is projected that millions of these injections are given each year in the United States. Ocular oncologists use intravitreal injections to treat such conditions as cystoid macular edema (CME), radiation retinopathy, and neovascularization. But did you know that the technique of delivering the injection can influence the effectiveness and safety of treatment?

Following IVT injection, some medication can actually egress or leave the eye through the port of entry, thus delivering less medication than what the physician intended. This can lead to under-treatment of the disease. The perfect IVT injection delivers an exact amount of medication with the least risk to vision and the eye.

Mehta and Finger used a technique of oblique (or angled) IVT injection in an effort to minimize the amount of medication leaving the eye. IVT injection was delivered at a 30-45 degree angle and compared to the standard technique of using a perpendicular (orthogonal) angle.

The researchers found that the angled IVT injection technique had a significantly higher mean intraocular pressure immediately after the injection. This finding suggests that angled injections are self-sealing and more of the drug is staying in the eye. Thus, the angled technique delivers a more accurate dose as well as prevents intraocular infection by closing a potential entry for pathogens.

The Figure below shows how the angled technique may allow for better retention of the drug within the eye following injection:

Through PubMed, you are able to read the published scientific article that explains this in detail here. To stay tuned on all the latest in eye cancer research, please keep our website, eyecancer.com, in your bookmarks!


Eye Injections 101

An intraocular injection (i.e., an injection made directly into the eye) may sound intimidating, uncommon, and dangerous. But did you know that intraocular injections are one of the most common surgical procedures practiced today in the United States? These injections are used mostly to treat macular degeneration, a deterioration of the sensitive, central portion of the retina (the macula) that makes it the leading cause of vision loss in Americans, more than cataracts and glaucoma combined (American Macular Degeneration Foundation). In 2005, Dr. Paul T. Finger discovered that these intraocular injections can be used towards another effect: in the vision-sparing treatment of radiation retinopathy.

Radiation retinopathy, or neuropathy, occurs as a side effect of the radiation used to treat orbital tumors or melanoma. When radiated, the retina and optic nerve may be progressively damaged over time, which can lead to permanent loss of vision if left untreated. Thus, intraocular injections of ANTI-VEGF therapy, such as Avastin or Eyelea, can help to suppress this retina and optic nerve damage caused by radiation treatment.

At The New York Eye Cancer Center, we aim to provide you with the best possible information regarding intraocular injections to ease any misgivings. We are constantly monitoring our patients who have undergone treatment to watch for signs of radiation retinopathy, and if injections of ANTI-VEGF therapy are required. For these patients, we have published a video that provides all necessary information regarding their expected injections, and what they can expect before, during, and after therapy. We stress, particularly, that treating radiation retinopathy is similar to the concept of treating hypertension (high blood pressure) or diabetes; the drugs administered will diminish the damage for these long-term medical conditions.

You can watch this video below at your convenience:

Eye Injection: Intraocular Injection at The New York Eye Cancer Center from Paul T Finger on Vimeo.

We have more upcoming videos available for public viewing at The New York Eye Cancer, so kindly consider keeping eyecancer.com in your bookmarks to stay tuned for them!


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