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Hamzah Khalaf, Victor H Gonzalez; Case Series Report of Safety of Serial Vitreous Needle Taps in Patients with Proliferative Diabetic Retinopathy (PDR) and Central Retinal Vein Occlusion (CRVO). Invest. Ophthalmol. Vis. Sci. 2017;58(8):1540. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Vitreous fluid analysis can potentially add crucial information to our understanding and treatment strategies for many retinal diseases. However, several concerns prevent researchers and clinicians from performing vitreous needle aspirations. These concerns include patient discomfort, low yield, and risk of retinal detachment. This report describes the safety profile of a standardized technique for serial vitreous needle aspirations performed by multiple physicians.
Serial vitreous taps were performed in patients with proliferative diabetic retinopathy and central retinal vein occlusion as part of existing clinical trials. Procedures were performed at bedside with oral or intravenous conscious sedation in an office or outpatient surgery setting. Maximum volume aspirated was 200uL using a needle customized for this purpose. When applicable, patients received an intravitreal injection after the vitreous tap.
As of August 2016, 40 patients were included with a total number of 118 vitreous aspirations. A range of 1-5 serial vitreous taps per eye were performed with 30% (n=12 patients) having more than 3 vitreous taps and 97.5% (n=39 patients) having more than 1 vitreous tap. 87% of the procedures were performed under intravenous conscious sedation at an outpatient surgery center (n=97 taps) and 22% under oral sedation at the office (n=21 taps). All attempted aspirations yielded sufficient vitreous volume with no acute or immediate serious adverse events. No cases of rhegmatogenous retinal detachments, retinal breaks, or endophthalmitis were reported in this study.
Our standardized vitreous tap technique is reliable with high yield for vitreous fluid and no safety concerns. In addition, it allows serial vitreous sampling at different stages of disease. This technique may allow researchers and clinicians to analyze the vitreous fluid on a large scale. Such analysis can yield invaluable molecular understanding, treatment targets, and prognostic markers.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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