Purchase this article with an account.
Fred Chu, Claire Kiernan, Norbert Becker, Anjali Hawkins; The Effect of Intravitreal Anti-VEGF Therapy on Intraocular Pressure. Invest. Ophthalmol. Vis. Sci. 2013;54(15):775.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To determine if there is an association between intravitreal injection of anti-VEGF therapies and the etiology of ocular hypertension (Intraocular pressure > 21). To determine what preoperative factors may be associated with ocular hypertension in patients receiving these intravitreal injections
This is a retrospective chart review of 202 eyes of 148 patients who underwent intravitreal injection of anti-VEGF therapy between January 2007 and December 2011. All injections were performed by the same surgeon (NB). Charts were reviewed for demographic information including age at first injection, diagnosis, pre-treatment IOP, glaucoma status, previous steroid use, and lens status. Post-treatment IOP, glaucoma medications and other glaucoma interventions were recorded. Anti-VEGF therapies included bevacizumab, ranibizumab, and pegaptanib. The primary outcome measure was initiation or escalation of glaucoma therapy (including ocular antihypertensive medications, laser trabeculoplasty and/or filtering or shunting surgeries). Data was analyzed at months 0, 1, and 3 and then in 3-month increments thereafter through December 2011.
Each eye underwent an average of 8.5 injections during the study period. During that time, 18 of 202 (8.9%) eyes required additional ocular anti-hypertensives at some point during follow-up. 16 of these 18 were not previously on antihypertensive treatment. At the end of the follow-up period, 8 of 202 (4.0%) eyes required sustained use of additional ocular anti-hypertensives as compared to their pre-treatment regimens. There was no significant difference between treatment requirements for phakic vs. pseudophakic patients (p = 0.215). There was no difference in age between the treated and untreated groups (p = 0.553). 1 of the 4 eyes previously diagnosed as “glaucoma suspect” required additional drops. 2 of the 11 eyes previously diagnosed with “glaucoma” required additional drops. 18 of 202 (8.9%) had sustained intraocular pressure (2 or more consecutive visits with IOP > 21 and 30% increase from baseline, or requiring additional ocular anti-hypertensives). 1 patient required laser trabeculoplasty and none required glaucoma filtering surgery.
A small but not insignificant percentage of patients receiving anti-VEGF injections may require transient or sustained anti-hypertensive therapy.
This PDF is available to Subscribers Only