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Valerie C. Lerebours, Jane S. Myung, MD, Jesse N. Cohen, Ben Z. Cohen, MD; Intraocular Pressure In Eyes Treated With Intravitreal Combination Of 1mg Triamcinolone Acetonide And 1.25mg Bevacizumab. Invest. Ophthalmol. Vis. Sci. 2012;53(14):881.
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To measure the intraocular pressure in eyes treated with intravitreal combination of 1mg of triamcinolone acetonide and 1.25mg of bevacizumab (TAB).
A retrospective chart review of 86 patients (135 eyes) with various retinal pathologies treated with intravitreal TAB from August 2009 to June 2011 by a single physician were reviewed. Indications for treatment included age related macular degeneration, clinically significant diabetic macular edema and venous occlusive disease. Baseline intraocular pressure was recorded prior to the first injection of TAB. The intraocular pressures at three separate office visits over a six month period after the initial injection were also obtained. All intraocular pressures were measured by the administering physician using a calibrated Goldmann applanation tonometer.
The mean baseline intraocular pressure prior to the initial intravitreal injection was 14.70 mmHg. The mean intraocular pressure prior to additional injections on three subsequent visits over a six month period was 14.81 ± 0.24 mmHg. The mean intraocular pressure immediately post injection on the same three visits was 15.49 ± 0.25 mmHg. Two eyes (2.33%) developed an intraocular pressure greater than 21mmHg during the post injection period. Twenty-seven eyes (31.40%) were on intraocular pressure lowering medications prior to receiving the combined therapeutic drug injection due to preexisting glaucoma. In this group, there was a mean increase of 0.69 mmHg between pre and post injection intraocular pressures with a mean number of 1.55 injections given to each eye over the 6 month period (P=0.006).
This study suggests that combination intravitreal 1mg triamcinolone acetonide and 1.25mg bevacizumab does not result in a significant increase in intraocular pressure. However, subgroup analysis of eyes with preexisting glaucoma showed a significant increase in intraocular pressure and may be a relative contraindication to use of this combination therapy.
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