Purchase this article with an account.
Emilie Agard, Hussam El Chehab, Ikrame Douma, Guillaume Ract-Madoux, Claude Dussart, Corinne Dot; Persistent ocular hypertension following intravitreal injections. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6304.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To report the rate of intraocular pressure elevation following repeated intravitreal injections (IVI) of anti-VEGF agents or dexamethasone intravitreal implants and to determine the risk factors.
A prospective study of 220 eyes undergoing IVI of ranibizumab (n=179), bevacizumab (n=22), or dexamethasone implant (n=19) was carried out. A total of 1340 IVI were performed. Intra ocular pressure (IOP) was measured by standard Goldman aplanation during the follow-up. Ocular hypertension (OHT) following these injections was diagnosed for an IOP superior to 25mmHg and investigated with respect to number of injections, pre-existing glaucoma, diabetes and YAG capsulotomy. Sub-groups analysis according to the different treatments were carried out.
After a mean of 5.8 IVI, 8.4% (n=18) had IOP elevation above 25 mmHg and required medical treatment (3% of them peaked above 30mmHg). Patients with pre-existing glaucoma experienced highter rates of OHT were compared to patients without pre-existing glaucoma (21.7mmHg +/-12.4 versus 17.23mmHg +/-4.5, p=0.06). No significant difference was found in diabetes subgroup (n=40, p=0.32), nor in YAG capsulotomy subgroup (n=12, p=0.8) compared to the control group. The peak of IOP was significatively correlated with the total number of IVI (p=0.01, R=0.19). The mean highest IOP was 17.2mmHg in ranibizumab group, 18.8mmHg in bevacizumab group and 19.9mmHg in dexamethasone intravitreal implant. No difference was found between these molecule subgroups (Kruskal-Wallis, p=0.38)
Serial intravitreal injections may lead to persistent IOP elevations that require IOP lowering therapies. This risk is correlated with the number of injections in our study and must be checked during the follow-up. Pre-existing glaucoma could be a risk factor but larger prospective studies are needed to verify these results.
This PDF is available to Subscribers Only