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Yoon Jeon Kim, Kyung Rim Sung, Yoo-Ri Chung, Kyoung Sub Lee, Soo Geun Joe, Joo Yong Lee, June-Gone Kim, Young Hee Yoon; Longterm effect of multiple intravitreal anti VEGF injection on intraocular pressure. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6301.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the longterm effect of multiple intravitreal anti-vascular endothelial growth factor (VEGF) injections on intraocular pressure (IOP) in eyes with neovascular age related macular degeneration (AMD) and retinal vein occlusion (RVO).
Patients who underwent multiple (more than 3 times) intravitreal anti-VEGF injections and were followed more than 12 months after last injection were consecutively enrolled. Clinical information such as baseline demographics, underlying disease, baseline IOP, and frequency of anti-VEGF injections were obtained via medical record review. IOP elevation was defined as increase of 5mmHg higher than baseline measurement on 2 consecutive visits. The frequency of IOP elevation was determined, and hazard ratio of each putative risk factor for IOP elevation was calculated using Cox proportional hazard model.
Six hundred and thirty nine eyes with neovascular AMD and 95 eyes with RVO were included in the analysis. Twenty eyes with neovascular AMD (3.0%) and 7 eyes with RVO (7.4%), showed IOP elevation after multiple anti-VEGF injections. In 27 eyes experiencing IOP elevation, IOP at the last follow up was 13.9 ± 2.3 mmHg, which was not significantly different from the baseline IOP, 13.4 ± 3.0 mmHg (P = 0.53). In neovascular AMD patients, history of IOP elevation associated with intravitreal steroid injections (34.465, P = 0.002), and history of glaucoma (4.201, P = 0.0285) were significant risk factors according to multivariate Cox proportional hazards. In RVO patients, history of glaucoma (7.217, P= 0.047) was a significant risk factors. In cox proportional hazard analysis of total participants incorporating underline disease as another variable, history of IOP elevation associated with intravitreal steroid injections (25.154, P = 0.002), history of glaucoma (5.294, P = 0.003), baseline IOP of treated eyes (0.826, P = 0.009), and diagnosis of RVO (2.959, P = 0.019) were significant risk factors for IOP elevation after multiple anti-VEGF injections.
The incidence of IOP elevation after multiple intravitreal anti-VEGF injections was low, and elevated IOP was normalized without medication in most of cases in our study.
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