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Ramanath Bhandari, Sara Ferri, Douglas R. Lazzaro, Eric M. Shrier; Bevacizumab and Sustained Intraocular Pressure Elevation, a Retrospective Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4877.
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Several recent studies indicate that intraocular pressure may fluctuate with intravitreal injection of Vascular Endothelial Growth Factor Inhibitors. The present study was undertaken to evaluate the effect of intravitreal injection of Bevacizumab (Avastin) on long term fluctuations of intraocular pressure (IOP) for treatment of Age Related Macular Degeneration (AMD).
A retrospective study was conducted on 22 eyes of 18 patients who received Bevacizumab (Avastin) for Age Related Macular Degeneration (AMD). IOP was measured using applanation tonometry. The average and peak IOP were compared pre and post injection at 1 month intervals to 90 days post injection.
There was no significant difference in average intraocular pressure pre and post injection by the Wilcoxon Signed Rank Test (p>0.05) with average intraocular pressure remaining at 14.6 mm Hg pre and post injection. However, there was an intraocular pressure spike at follow up visits post injection that was significant by the Wilcoxon Signed Rank Test (p<0.05) with the intraocular pressure transiently rising on average 1.4 mm Hg at follow up visits. The greatest transient rise in IOP post injection was 6 mm Hg in a patient with a maximum intraocular pressure of 28 mm Hg. However, 8 of the 22 eyes did not have an intraocular pressure spike post injection.
From our study, intravitreal injection of Bevacizumab (Avastin) may result in transient IOP elevation up to 90 days post injection, however, the effect is typically not sustained indicating that for most patients, intraocular pressure elevation should not be a concern with injection of intravitreal vascular endothelial growth factor inhibitors.
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