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M. J. Siegel, B. A. Hughes, M. S. Juzych, M. Y. Alexander, A. Goyal, S. Wolfe, C. Kim; Effect of Intravitreal Bevacizumab (Avastin) on Intraocular Pressure in Patients With and Without Glaucoma. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2485.
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This study compares changes in intraocular pressure (IOP) in patients without glaucoma, patients with primary open-angle glaucoma (POAG) as well as neovascular glaucoma (NVG) after receiving intravitreal bevacizumab (Avastin).
This is a retrospective study of patients who received intravitreal injections of Avastin (1.25mg/0.05 ml) between January 2006 and January 2008. The indications for Avastin injections included clinically significant macular edema, macular degeneration, posterior segment ischemia due to central retinal vein occlusion and proliferative diabetic retinopathy. IOP was measured by Goldmann applanation tonometry pre-injection and again at the next post-injection follow-up visit. IOP measurements were analyzed using paired t-test analysis. Cohort groups included all patients, non-glaucoma patients, patients with POAG and patients with NVG.
Five hundred and twelve charts were reviewed of patients with retinal disorders of which 153 eyes of 148 patients were found to have received intravitreal injection of Avastin. The mean age was 75.9 years. Seventy-nine were female and 69 were male. Forty were being treated for POAG and twelve were being treated for NVG. The mean IOP pre-injection was 15.6 mmHg for all patients, 17.3 mmHg for patients with POAG, 18.9 mmHg for patients with NVG, and 14.5 mmHg for patients without glaucoma. Post-injection IOPs were recorded at the next follow-up visit with mean IOP values of 15.3 mmHg, 17.2 mmHg, 18.25 mmHg, and 14.1 mmHg, respectively, for all patients, patients with POAG, patients with NVG, and patients without glaucoma. Average time to follow-up IOP measurement was 34.1 days for all patients, 32.3 days for patients with POAG, 33.4 days for NVG patients, and 34.9 days for non-glaucoma patients. The average IOP reduction was 0.28 mmHg (p=0.45) for all patients, 0.08 mmHg (p=0.93) for POAG, 0.67 mmHg (p=0.79) for NVG, and 0.32 mmHg (p=0.33) for non-glaucoma patients.
Our data suggests that intravitreal Avastin has no appreciable effect on IOP in patients with or without glaucoma or in patients with NVG one month following injection. Therefore, intravitreal Avastin may be safely injected in patients with and without glaucoma for the treatment of diagnosed retinal disorders without risk of intraocular pressure change.
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