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Kundandeep Nagi, Olga Shif, Aimee Lam; Intraocular pressure profile associated with intravitreal aflibercept injections. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5058.
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© ARVO (1962-2015); The Authors (2016-present)
The effect of intravitreal injections on intraocular pressure (IOP) is unknown. We desribe the IOP profile in such patients recieving this treatment for wet age-related macular degeneration and macular edema related to retinal vascular occlusions.
An IRB approved retrospective chart review of patients treated with more than one injection of aflibercept for wet age-related macular degeneration or macular edema due to a retinal vascular occlusion. Records of patients with monocular injections were selected and their untreated eyes served as the control. Exclusion criteria included patients with a previous diagnosis of glaucoma/ocular hypertension, or those that received an intravitreal injection of another anti-VEGF drug less than 40 days prior to injection with aflibercept. IOPs were recorded at the initial visit followed by each subsequent injection appointment. Data was reviewed using standard paired t-test and repeated measures ANOVA analyses.
Of the 50 patient charts (23 male, 27 female) reviewed, 48 had exudative macular degeneration in one eye and only 2 carried the diagnosis of retinal vein occlusion. Ages ranged from 57 to 94 years. Patients were injected with aflibercept approximately every 4 to 8 weeks with treatment periods spanning from 8 weeks to 2.5 years. No patient had developed an IOP elevation that required treatment with glaucoma medication. Statistical analysis of IOPs in the eyes treated with aflibercept vs. controls revealed a statistically significant decrease in intraocular pressures (0.5 mm Hg) of the treated eyes with a 95% confidence level (p value = 0.024).
This review describes a statistically significant IOP decrease in non-glaucomatous nonhypertensive eyes receiving intravitreal aflibercept injections for exudative macular degeneration and retinal vein occlusions. Given the prevalence and co-existence of glaucoma and macular degeneration, additional studies would be important to determine if this effect is constant among glaucomatous eyes or if there is a paradoxical effect on IOP and precautionary measures should be taken when injecting these patients with aflibercept.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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