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Greener intravitreal injections: a narrative review

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Abstract

Healthcare services are significant contributors to climate change. Ophthalmology, by virtue of the volume of appointments and procedures it generates, is thought to play a major role in this regard. Intravitreal injections (IVI) are a commonly performed ophthalmological procedure to treat patients with conditions such as macular neovascularisation secondary to neovascular age-related macular disease or myopia, diabetic macular oedema, and retinal vein occlusions. As IVIs become more ubiquitous, addressing their environmental impact and sustainability will become increasingly important. Strategies to tackle carbon emissions from IVIs may target the following areas which align with the Greenhouse Gas Protocol scopes: building energy; water consumption; travel to appointments; manufacture and procurement of the drug and other necessary materials; and waste disposal. We propose a path towards a more sustainable approach for IVIs, and discuss its potential safety as well as the patient experience.

摘要

医疗保健服务是气候变化的一个重要因素。 眼科因其预约和手术大, 而被认为在这方面发挥着重要作用。玻璃体内注射 (IVI) 是一种常见的眼科手术, 用于治疗继发于新生血管性老年性黄斑病变或**视、糖尿病性黄斑水肿和视网膜静脉阻塞等继发的黄斑新生血管患者。当这种手术越来越普遍的时候, 解决其环境影响和可持续性将越来越重要。

应对IVIs 碳排放的战略可以针对以下符合温室气体议定书 (GHGP) 范围中的领域: 建筑能源和水消耗；预约就诊旅行；药物和其他必需品的制造和采购；以及废品处理。我们提出了一套 IVIs的可持续方案, 并讨论了其潜在的安全性以及患者体验。

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Fig. 1: Trends demonstrating the increasing number of patients that attended the intravitreal injection clinic every week (black), and the number of injections administered (grey), between August 2008 to December 2019 (inclusive), at Moorfields Eye Hospital.

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Funding

This work was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC). The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.

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Authors and Affiliations

  1. Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK

    Ariel Yuhan Ong, Johannes Birtel & Peter Charbel Issa

  2. Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

    Ariel Yuhan Ong, Johannes Birtel & Peter Charbel Issa

  3. Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Johannes Birtel

  4. Department of Ophthalmology, Technical University Munich, Munich, Germany

    Peter Charbel Issa

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  1. Ariel Yuhan Ong
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AYO: Conceptualisation; Data curation; Investigation; Resources; Writing—original draft, review, editing. JB: Resources; Writing—review, editing. PCI: Conceptualisation; Writing—review, editing.

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Correspondence to Peter Charbel Issa.

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Ong, A.Y., Birtel, J. & Charbel Issa, P. Greener intravitreal injections: a narrative review. Eye (2024). https://doi.org/10.1038/s41433-024-03185-z

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