Abstract
Purpose:
To determine changes in the intraocular pressure (IOP) in patients receiving intravitreal injection of 4 Anti-VEGF Medication (bevacizumab, pegaptanib, ranibizumab, aflibercept).
Methods:
This was a retrospective chart review of eighty five consecutive patients who received intravitreal Anti-VEGF medication for various conditions such as exudative age-related macular degeneration, venous occlusions, proliferative diabetic retinopathy and diabetic macular edema. IOP was measured using a Reichert Tono-Pen® XL Applanation Tonometer before and 1 minute after intravitreal injection.
Results:
Out of the 85 patients 70% were female, and 30% were male with an average age of 74.4 years. 50% of the patients were being treated for exudative age-related macular degeneration, diabetic macular edema 27%, proliferative diabetic retinopathy 13%, and vein occlusions 10%. 56% were injected with ranibizumab, 20% with pegaptanib, 19% with bevacizumab and 5% with aflibercept. Baseline median IOP was 15 mmHg (Max Value 22 mmHg and Min Value 12 mmHg). 1 minute after the injection the IOP rose from a high value of 89 mmHg to a low of 15 mmHg with a median of 60 mmHg. With ranibizumab the IOP rose from a a high value of 89 mmHg to a low value of 24 mmHg with a median of 59.50 mmHg, with bevacizumab the IOP rose from a high value of 87 mmHg to a low of 15 mmHg with a median of 55 mmHg, with aflibercept the IOP rose from a high value of 75 mmHg to a low value of 54 mmHg with a median of 58.50 mmHg and with pegaptanib the IOP rose from a high value of 89 mmHg to a low value of 33 mmHg with a median of 86 mmHg.
Conclusions:
All medications had a significant elevation of IOP with pegaptanib having the highest elevation probably related to the higher volume of pegaptanib that needs to be injected (0.09 ml). The elevation in IOP demonstrated in this study is significant enough to justify a focused study on possible long-term side effects secondary to this acute IOP elevation.
Keywords: 568 intraocular pressure •
427 aqueous •
633 outflow: trabecular meshwork