Ophthalmologie

Des études ont révélé que l’administration prophylactique d’antibiotiques locaux n’influence pas le risque d'endophtalmie en cas d’injections intravitréennes. Une désinfection préopératoire appropriée selon les lignes directrices internationales s’avère suffisante. La diminution de l’utilisation d’antibiotiques réduit la sélection de germes résistants.

^{Références:}

^{American Academy of Ophthalmology, Practicing Ophthalmologists Learning System. Intravitreal injections [Internet]. San Francisco: American Academy of Ophthalmology, 2008 Nov.; Available from: one.aao.org/CE/PracticeGuidelines/ClinicalStatements_Content.aspx?cid=404813e9-b3dc-4d6d-a2c5-d1f1e78a926b#section4.}

^{Bhavsar AR, Googe JM, Stockdale CR Bressler NM, Brucker AJ, Elman MJ, Glassman AR. Diabetic Retinopathy Clinical Research Network. Risk of endophthalmitis after intravitreal drug injection when topical antibiotics are not required. The Diabetic Retinopathy Clinical Research Network Laser-Ranibizumab-Triamcinolone Clinical trials. Arch Ophthalmol [Internet]. 2009 Dec;127(12):1581-3.}

^{Scott IU, Flynn HW. The role of topical antibiotic prophylaxis for intravitreal injections. Arch Ophthalmol [Internet]. 2007 Jul;125(7):974-6.}

^{Bhatt SS, Stepien KE, Joshi K. Prophylactic antibiotic use after intravitreal injection: Effect on endophthalmitis rate [Internet]. Retina. 2011 Nov;31(10):2032-6.}

^{Kim SJ, Toma HS, Midha, Cherney EF, Recchia FM, Doherty TJ. Antibiotic resistance of conjunctiva and nasopharynx evaluation study: A prospective study of patients undergoing intravitreal injections. Ophthalmol [Internet]. 2010 Dec(12):117-2372-8.}

^{Kim SJ, Toma KS. Ophthalmic antibiotics and antimicrobial resistance. A randomized, controlled study of patients undergoing intravitreal injections. Ophthalmol [Internet]. 2011 Jul(7);118:1358–1363.}

^{Cheung CSY; Wong AWT, Kertes PJ, Devenyi RG, Lam WC. Incidence of endophthalmitis and use of antibiotic prophylaxis after intravitreal injections. Ophthalmol [Internet]. 2012 Aug:119(8):1609-14.}

^{Milder E, Vander J, Shah C, Garg S. Changes in antibiotic resistance patterns of conjunctival flora due to repeated use of topical antibiotics after intravitreal injections. Ophthalmol [Internet]. 2012 Jul:119(7):1420-4.}

Dans le cadre des interventions susmentionnées, le risque hémorragique périopératoire est très faible et il n’est pas augmenté de façon significative par la prise d'antiagrégants plaquettaires ou d'anticoagulants. En revanche, l’interruption de ces traitements accroît le risque de complications thromboemboliques chez les patients et elle n’est pas justifiable pour les interventions mentionnées.

^{Références:}

^{Loukopoulos V, Meier C, Gerding H . Hemorrhagic complications after intravitreal injections of ranibizumab in patients under coumarin-type anticoagulation. Klin Monbl Augenheilkd 2010; 227 (4): 289–291.}

^{Mason JO 3rd, Frederick PA, Neimkin MG, White MF Jr, Feist RM, Thomley ML et al. Incidence of hemorrhagic complications after intravitreal bevacizumab (avastin) or ranibizumab (lucentis) injections on systemically anticoagulated patients. Retina 2010; 30 (9): 1386–1389.}

^{Solomon SD, Lindsley K, Vedula SS, Krzystolik MG, Hawkins BS. Anti-vascular endothelial growth factor for neovascular age-related macular degeneration. Cochrane Eyes and Vision Group, ed. Cochrane Database of Systematic Reviews. Published online August 29, 2014.}

^{Makuloluwa AK, Tiew S, Briggs M. Peri-operative management of ophthalmic patients on anti-thrombotic agents: a literature review. Eye (Lond). 2019;33(7):1044-1059.}

Le recours à des techniques d’imagerie (par ex. tomographie en cohérence optique; photographie du fond d’œil) n’est pas indiqué en l’absence de symptômes, de signes cliniques ou de conséquences thérapeutiques. Un usage adéquat des modalités d’imagerie modernes contribue à la réduction des coûts et à la préservation des ressources dans le domaine de la santé.

^{Références:}

^{American Academy of Ophthalmology Preferred Practice Patterns Committee. Preferred Practice Pattern® Guidelines. Comprehensive Adult Medical Eye Evaluation [Internet]. San Francisco, CA: American Academy of Ophthalmology;2010}

^{American Academy of Ophthalmology Retina Panel. Preferred Practice Pattern® Guidelines. Idiopathic Macular Hole [Internet]. San Francisco, CA: American Academy of Ophthalmology; 2008}

^{American Academy of Ophthalmology Retina Panel. Preferred Practice Pattern® Guidelines. Age-Related Macular Degeneration [Internet]. San Francisco, CA: American Academy of Ophthalmology; 2008}

^{American Academy of Ophthalmology Retina Panel. Preferred Practice Pattern® Guidelines. Diabetic Retinopathy [Internet]. San Francisco, CA: American Academy of Ophthalmology; 2008}

^{Javitt JC, Canner JK, Frank RG, Steinwachs DM, Sommer A. Detecting and treating retinopathy in patients with Type 1 diabetes mellitus – A health policy model. Ophthalmology. 1990;97(4):483-95.}

^{Khalaf SS, Al-bdour MD, Al-Til MI. Clinical biomicroscopy versus fluorescein angiography: effectiveness and sensitivity in detecting diabetic retinopathy. E J Ophthalmol. 2007;17(1):84–88.}

^{McDonald HR, Williams GA, Scott IU, Haller JA, Maguire MA, Marcus DM. Laser scanning imaging for macular disease: a report by the American Academy of Ophthalmology. Ophthalmology [Internet]. 2007;114:1221-8.}

^{Wilkinson CP. The clinical examination. Limitations and overutilization of angiographic services. Ophthalmology. 1986;93(3):401-4.}

^{Wykes WN, Livesay S. Review of fluorescein angiographs performed in one year. Brit J Ophthalmol [Internet].1991;75(7):398–400.}

^{Macular Photocoagulation Study Group. Argon laser photocoagulation for neovascular maculopathy. Five-year results from randomized clinical trials. Arch Ophthalmol [Internet]. 1991;109(8):1109-14.}

^{Macular Photocoagulation Study Group. Laser photocoagulation of subfoveal neovascular lesions of age-related macular degeneration. Updated findings from two clinical trials. Arch Ophthalmol [Internet]. 1993;111(9):1200-9.}

^{Macular Photocoagulation Study Group. Laser photocoagulation for juxtafoveal choroidal neovascularization. Five-year results from randomized clinical trials. Arch Ophthalmol [Internet]. 1994;112(4):500-9.}

^{Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol [Internet]. 1985;103(12):1796-806.}

^{Early Treatment Diabetic Retinopathy Study Research Group. Focal photocoagulation treatment of diabetic macular edema. Relationship of treatment effect to fluorescein angiographic and other retinal characteristics at baseline: ETDRS report number}

^{Arch Ophthalmol [Internet]. 1995;113(9):1144-55.}

L’opération de la cataracte est une indication relative, qui doit être posée en prenant en considération à la fois les souhaits du patient et le risque opératoire individuel. Ce n’est que dans de rares cas que l’opération s’avère absolument nécessaire. Cela peut être le cas lorsqu’une non-intervention pourrait se solder par une atteinte visuelle permanente – par ex. dans le cadre d’une cataracte intumescente avec perturbation de la pression intraoculaire.

^{Références:}

^{Kessel L, Andresen J, Erngaard D, Flesner P, Tendal B & Hjortdal J (2016): Indication for cataract surgery. Do we have evidence of who will benefit from surgery? A systematic review and meta‐analysis. Acta Ophthalmol 94: 10– 20.}

^{Lundström M, Goh P‐P, Henry Y, Salowi MA, Barry P, Manning S, Rosen P & Stenevi U (2015): The changing pattern of cataract surgery indications – a five‐year study of two cataract surgery databases. Ophthalmology 122: 31– 38.}

^{Lundström M, Barry P, Henry Y, et al. Evidence-based guidelines for cataract surgery: Guidelines based on data in the European Registry of Quality Outcomes for Cataract and Refractive Surgery database. Journal of Cataract & Refractive Surgery 2012;38:1086–93.}

^{Kessel L, Andresen J, Erngaard D, Flesner P, Tendal B & Hjortdal J (2016): Indication for cataract surgery. Do we have evidence of who will benefit from surgery? A systematic review and meta‐analysis. Acta Ophthalmol 94: 10– 20.}

^{Lundström M, Goh P‐P, Henry Y, Salowi MA, Barry P, Manning S, Rosen P & Stenevi U (2015): The changing pattern of cataract surgery indications – a five‐year study of two cataract surgery databases. Ophthalmology 122: 31– 38.}

^{Lundström M, Barry P, Henry Y, et al. Evidence-based guidelines for cataract surgery: Guidelines based on data in the European Registry of Quality Outcomes for Cataract and Refractive Surgery database. Journal of Cataract & Refractive Surgery 2012;38:1086–93.}