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Sabin Dang, Sonia Rana, Cajal Patel, Johnstone Kim, Asheesh Tewari; Short Term Intraocular Pressure Changes After Intravitreal Injection in Patients with Glaucoma. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2672.
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The use of intravitreal injections to treat retinal disease is increasing. Multiple studies have reported short-term increased intraocular pressure (IOP) elevations after injection. Our group hypothesizes that impaired aqueous outflow in patients with glaucoma predisposes them to an increased post intravitreal injection IOP elevation.
We performed a retrospective analysis of all patients who received intravitreal ranibizumab injections over a 6-month period. The charts were reviewed and pre-injection as well as 5- and 10- min post injection IOP was recorded. The charts were reviewed to determine if patients had a documented glaucoma diagnosis. Additional clinical variables recorded included: cup-to-disc ratio, phakic status, number of glaucoma medications, and reason for intravitreal injection.
A total of 42 patients received ranibizumab during the study time period. 10 patients had existing diagnoses of primary open angle glaucoma (POAG). There was no statistical difference between the mean pre-injection IOP for the glaucoma group and the control group (mean 15.81, p = 0.67). Both the glaucoma group and the control group had a statistically significant increase in IOP at the 5- and 10- minute checks relative to pre-injection IOP (p < 0.01 for both groups). There was no significant interaction between subject’s glaucoma status and IOP (p = 0.27).
Our data suggests that there is a trend towards increased IOP in patients with glaucoma relative to those without. However, this effect appears to be of short duration. Given this information, there appears to be little benefit in pre-treatment with IOP lowering medications in patients with known diagnoses of glaucoma who are also receiving intravitreal medications.
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