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Quan V. Hoang, Ron Margolis, Vivian Chin, Angela J. Tsuang, K. Bailey Freund; Long-Term Effect of Intravitreal Anti-Vascular Endothelial Growth Factor Therapy on Intraocular Pressure. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1690.
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To report the long-term effect of intravitreal anti-vascular endothelial growth factor (VEGF) injections on intraocular pressure (IOP).
133 patients without prior history of glaucoma with treatment-naïve age-related macular degeneration (AMD) treated with intravitreal anti-VEGF agents and followed for an average of 21.2 months were retrospectively reviewed for elevations in IOP (in mmHg, defined as either IOP ≥ 21, ≥ 25, or a ≥ 6 increase in IOP from baseline). The associations between number of injections and change in IOP from baseline in both treated and untreated eyes were analyzed.
A total of 149 eyes of 133 patients were included in this study. The mean patient age at the initiation of treatment was 81 years, 65% were female, and 61% of eyes were phakic. Mean pre-treatment IOP was 14.9 (standard deviation, SD 2.4, range 10-20). The mean number of total injections was 14.3 (SD 9.4, range 1-35). Overall, 8 patients (6%) experienced an elevation in IOP. Logistic regression showed a significant effect of the total number of injections on the probability of a measured IOP being ≥ 22 vs. < 22 (p = 0.010), or ≥ 25 vs. < 25 (p = 0.035), and of a ≥ 6 increase in IOP from baseline (p = 0.031). Mean number of injections received was significantly higher in those patients with an IOP ≥ 22 (26.6 injections) than those with IOP < 22 (13.7 injections, p = 0.005, two-tailed, two-sample t-test), and in those with an IOP ≥ 25 (28.3 injections) than those with IOP < 25 (13.9 injections, p = 0.008).
In treatment-naïve age-related macular degeneration patients without a prior history of glaucoma, the total number of intravitreal anti-VEGF injections is a predictor of elevation in IOP.
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