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C. R. Sanchez, J. E. Kim, D. J. Covert; Intraocular Pressure Changes Immediately Following Intravitreal Injections of Ranibizumab and Bevacizumab. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1893.
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To assess factors affecting intraocular pressure (IOP) immediately following intravitreal injections of ranibizumab and bevacizumab using 32 gauge needles.
This was a retropective record review of 137 injections of 137 patients undergoing their first intravitreal injection of either ranibizumab or bevacizumab for any clinical indication. Intraocular pressure was measured prior to injection and immediately following injection. Age, gender, lens status, history of glaucoma, and occurrence of vitreous fluid reflux immediately after injection were documented.
Sixty men and 77 woman were included. Mean age at time of intravitreal injection was 75.7 +/- 12.2 years (range: 43-94). Mean baseline IOP prior to injection was 16.5 mmHg (range: 8-24). No statistical differences in baseline IOP were observed when stratified by glaucoma status (p=0.64), age (p=0.19), lens status (p=0.3), or medication injected (p=0.89). The mean IOP immediately after injection was 47.1 mmHg (range: 15-85), resulting in a mean change in IOP (delta-IOP) of 30.2 mmHg (range: 1-61). No statistical differences in delta-IOP were observed when stratified by glaucoma status (p=0.58), age (p=0.11), lens status (p=0.50), or medication injected (p=0.60) . Delta-IOP was lower in patients who experienced reflux (26.7 mmHg) compared to patients who did not have reflux (32.2 mmHg) which was statistically significant (p=0.004).
In this study, the change in IOP immediately after intravitreal injection did not vary as a function of glaucoma status, age, lens status, or type of anti-VEGF agent injected. The presence of reflux was associated with a 5.5 mmHg blunting of the IOP spike immediately after injection compared to those without observed reflux.
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