Purchase this article with an account.
Nurit Mathalone, Anat Arodi Golan, Shaul Sar, Yulia Wolfson, Mordechai Shalem, Orna Geyer; Sustained IOP Elevation Associated With Intravitreal Bevacizumab Injections In AMD Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5924.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Intravitreal bevacizumab injections have become a widespread treatment for neovascular AMD. Several case reports and a recent study of 101 eyes have described intra-ocular pressure (IOP) elevation after repeated injections. We wanted to study a large group of patients treated in our retina clinic and evaluate the incidence and possible risk factors for IOP elevation after repeated intravitreal bevacizumab injections in neovascular age-related macular degeneration (AMD) patients.
We reviewed the charts of 203 consecutive patients (235 eyes) treated in our retina clinic with intravitreal bevacizumab for AMD. Data collected for each patient included: IOP before the initiation of treatment, before each subsequent injection and at the end of follow up; number of injections; length of follow up and the presence of glaucoma before treatment. Patients with preexisting uncontrolled glaucoma were excluded. Sustained IOP elevation was defined as ≥ 22 mmHg for more than 30 days.
Sustained IOP elevation was observed in 29 of 235 (12%) treated eyes. Of these 22 required medications to control IOP. Mean IOP at the time of elevation diagnosis was 25 mmHg (range 22-36). There was no statistical difference in post-injection IOP elevation between patients with or without preexisting glaucoma. There was no correlation between IOP at the end of follow up or at the time of IOP elevation and: pre-injection IOP; length of follow up and number of injections. The only statistically significant difference was the mean interval between injections: 2.45 months in patients without and 1.9 months in patients with sustained IOP elevation (p=0.043).
AMD patients undergoing repeated intravitral bevacizumab injections, especially when frequent, are at an increased risk of sustained IOP elevation. Regular IOP measurements and IOP-lowering treatment in patients with persistent elevation are recommended.
This PDF is available to Subscribers Only