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Yusuke Ichiyama, Tomoko Sawada, Masashi Kakinoki, Osamu Sawada, Yoshitsugu Saishin, Hajime Kawamura, Masahito Ohji; A lack of delayed intraocular pressure elevation after intravitreal injections of ranibizumab for age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6300.
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To evaluate the delayed intraocular pressure (IOP) elevation after intravitreal injections of ranibizumab for age-related macular degeneration (AMD).
The charts of patients treated with intravitreal ranibizumab injections for exudative AMD and followed monthly for 12 months or longer were retrospectively reviewed. The treatment regimen included three consecutive monthly injections followed by a PRN dosing strategy. IOP was measured at every follow up visit with noncontact tonometer (NIDEK NT-4000 Non-Contact Tonometer). Delayed IOP elevation was defined as an IOP ≥22 mmHg on 2 consecutive visits with an increase from baseline >6 mmHg. In patients who received injection of ranibizumab to one eye, fellow untreated eyes served as controls. Eyes with glaucoma were also evaluated separately.
A total of 111 eyes met inclusion criteria. Delayed IOP elevation was not found in any eyes in this study. The mean duration of follow up was 18.7±4.6 months. The mean number of injections was 4.4±1.4 for 12 months and 6.0±3.1 during the follow up period, both including the 3 initial injections. The mean IOP of all eyes at baseline was 12.9±3.1mmHg. The highest mean IOP during the follow up period was 12.9±3.0mmHg at month 21, which was not significantly different compared with the mean IOP at baseline (P=0.94). In the patients who received treatment to one eye, there was no significant difference in the mean IOP between the treated eyes and the control eyes. There were 9 eyes with AMD and glaucoma. The mean IOP was 13.0±4.4mmHg at baseline and the highest mean IOP during the follow up period was 13.0±4.0mmHg at month 23, which was not significantly different compared with the mean IOP at baseline (P=0.99). In the patients with glaucoma who received treatment to one eye, there was no significant difference in the mean IOP between the treated eyes and control eyes during the follow up period.
Repeated injection of ranibizumab was not associated with an increased risk for IOP elevation.
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