April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Predictors of Sustained Intraocular Pressure Elevation in Patients Receiving Anti-Vascular Endothelial Growth Factor Therapy for Neovascular Age-Related Macular Degeneration
Author Affiliations & Notes
  • Fumitaka Sugiguchi
    Weill Cornell Medical College, New York, NY
    LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Institute, New York, NY
  • Nicolas A Yannuzzi
    Weill Cornell Medical College, New York, NY
    LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Institute, New York, NY
  • Samir N Patel
    Weill Cornell Medical College, New York, NY
    LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Institute, New York, NY
  • Kavita Bhavsar
    LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Institute, New York, NY
    Vitreous Retina Macula Consultants of New York, New York, NY
  • K Bailey Freund
    LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Institute, New York, NY
    Vitreous Retina Macula Consultants of New York, New York, NY
  • Footnotes
    Commercial Relationships Fumitaka Sugiguchi, None; Nicolas Yannuzzi, None; Samir Patel, None; Kavita Bhavsar, None; K Bailey Freund, Alimera (C), Genentech (C), Heidelberg Engineering (C), Optos (C), Regeneron (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4964. doi:
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      Fumitaka Sugiguchi, Nicolas A Yannuzzi, Samir N Patel, Kavita Bhavsar, K Bailey Freund; Predictors of Sustained Intraocular Pressure Elevation in Patients Receiving Anti-Vascular Endothelial Growth Factor Therapy for Neovascular Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4964.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To determine predictors of sustained intraocular pressure (IOP) elevation in patients treated with intravitreal anti-vascular endothelial growth factor (VEGF) therapy for neovascular age-related macular degeneration (NV AMD) using a cross sectional physician survey.

 
Methods
 

530 retina specialists were surveyed regarding current anti-VEGF intravitreal injection protocols including the anti-VEGF drug of choice, needle size, injection volume, injection technique, and self-reported prevalence of sustained IOP elevation. Multivariate logistic regressions were performed to assess the influence of these factors on long-term IOP.

 
Results
 

There was no relationship between the frequency of sustained IOP elevation and anti-VEGF drug of choice. Participants using 31 gauge needles were 2.8 times more likely to observe a high frequency of sustained IOP elevation than those who used 27, 30, or 32 gauge needles (p=0.028). Physicians who injected greater than 0.05cc in less than one second were over 5 times more likely to observe a high frequency of sustained IOP elevation (p<0.01).

 
Conclusions
 

Serial anti-VEGF injections using either 31 gauge needles, higher injection volumes, and a rapid injection technique may lead to sustained IOP elevations. The underlying mechanism may relate to rapid elevations in IOP inducing injury to the trabecular meshwork. Further investigation of the relationship between injection technique and sustained IOP elevation is warranted.

     
Keywords: 568 intraocular pressure • 412 age-related macular degeneration • 561 injection  
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