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Concept
Intravitreal injection
Summary
Intravitreal injection is the method of administration of drugs into the eye by injection with a fine needle. The medication will be directly applied into the vitreous humor. It is used to treat various eye diseases, such as age-related macular degeneration (AMD), diabetic retinopathy, and infections inside the eye such as endophthalmitis. As compared to topical administration, this method is beneficial for a more localized delivery of medications to the targeted site, as the needle can directly pass through the anatomical eye barrier (e.g. cornea, conjunctiva and lens) and dynamic barrier (e.g. tears and aqueous humor). It could also minimize adverse drug effects on other body tissues via the systemic circulation, which could be a possible risk for intravenous injection of medications. Although there are risks of infections or other complications, with suitable precautions throughout the injection process, chances for these complications could be lowered.
Intravitreal injection was first mentioned in a study in 1911, in which the injection of air was used to repair a detached retina. There were also investigations evaluating intravitreal antibiotics injection using sulfanilamide and penicillin to treat endophthalmitis in the 1940s, yet due to the inconsistency of results and safety concerns, this form of drug delivery was only for experimental use and not applied in patients. It was until 1998, that fomivirsen (VitraveneTM), the first intravitreal administered medication, was approved by the U.S. Food and Drug Administration (FDA).
In 2004, when Aiello et al. published the first guidelines for intravitreal injection in the journal ‘Retina’, fomivirsen was still the only medication licensed by the FDA for intravitreal injection. At the end of the year, on December 17, the first intravitreal anti-VEGF drug pegaptanib (Macugen) was also licensed by FDA for treatment of wet age-related macular degeneration (wet AMD).
Intravitreal injection has then become more common and a surge in the number of injections performed could be seen.
Official source
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