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G. J. Mojica, S. M. Hariprasad, C. Radhakrishnan, D. A. Mazzulla, W. F. Mieler; Short-Term Intraocular Pressure Trends Following Intravitreal Injection of Ranibizumab (Lucentis) for the Treatment of Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):258.
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The recent FDA approval of ranibizumab for the treatment of choroidal neovascularization (CNV) due to age-related macular degeneration (ARMD) has led to a dramatic rise in the number of intravitreal injections performed. The primary aim of this study is to assess short-term changes in intraocular pressure (IOP) following intravitreal injection of 0.5mL of ranibizumab.
A retrospective chart review of all patients who received intravitreal injections of ranibizumab between July 1 and September 31, 2006 was performed. An analysis of IOP measured by Goldmann applanation tonometry pre-injection, 20-30 minutes post-injection, and at the first follow-up visit was conducted. The preoperative diagnosis, as well as the presence of glaucoma, was noted. Analysis of data was accomplished using a paired t-test and statistical significance was determined.
A total of 16 injections in 10 patients met the inclusion criteria. The average pre-injection IOP was 13.8 mmHg (range: 9-22 mmHg) and average post-injection IOP was 20.4 mmHg (range: 10-24 mmHg). The difference between pre and post-injection IOP was 6.6 mmHg (p=0.00014). The first follow-up visit occurred at an average of 7.9 days after the injection and average IOP was 13.9 mmHg. The difference between the pre-injection IOP and the IOP measured at first follow-up visit was not statistically significant (p=0.9381).
The results of this study revealed that while IOP does rise within 30 minutes of intravitreal injection of ranibizumab, none of the patients experienced a rise in IOP substantial enough to require treatment. In addition, IOP at one week follow-up was not statistically different than baseline. Findings of this study suggest that measuring IOP 30 minutes after ranibizumab injection may not be necessary and anterior chamber paracentesis immediately after injection is not recommended.
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