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S. L. Prabakaran, A. M. Eaton, H. Wafapoor; Changes in Intraocular Pressure After Intravitreal Injection of Bevacizumab (Avastin) and Ranibizumab (Lucentis). Invest. Ophthalmol. Vis. Sci. 2008;49(13):2101.
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To evaluate the changes in intraocular pressure (IOP) following intravitreal injections of Bevacizumab and Ranibizumab for the treatment of retinal disorders.
This is a retrospective study of 143 eyes who received an intravitreal injection of 1.25 mg Bevacizumab in 0.05 ml or Ranibizumab 0.5 mg in 0.05 ml. The majority of the patients (133) were being treated for exudative age-related macular degeneration. Seven of the patients had proliferative diabetic retinopathy and three of the patients had retinal vein occlusion. The IOP was measured prior to and between four and seventeen minutes after injections with a mean time of 7.6 minutes. Statistical analysis was performed.
All 143 eyes received a single injection. Baseline mean IOP was 13.24 mm Hg, with range from 7 mm Hg to 30 mm Hg. Post injection IOP showed a rise with a mean of 18.72 mm Hg and a range from 7 mm Hg to 29 mm Hg. None of the patients had a post injection IOP above 29 mm Hg. The increase in IOP after injections was statistically significant at the 95% confidence level (P=< .05).Bevacizumab versus Ranibizumab:Of the total 143 eyes injected, 88 received Bevacizumab and 55 received Ranibizumab. Average increase in IOP for eyes that received Ranibizumab was 7.38 mm Hg, and the average increase in IOP for eyes that received Bevacizumab was 6.52 mm Hg. This was not statistically significant.Glaucoma Versus non-glaucoma Patients:Of the total 143 eyes injected, 8 had glaucoma and 135 did not have glaucoma. Of the 88 eyes treated with Bevacizumab, 4 had glaucoma and 84 did not. Of the 55 eyes treated with Ranibizumab, 4 had glaucoma and 51 did not. The average increase in IOP for eyes with glaucoma treated with Bevacizumab was 8.25 mm Hg, and without glaucoma was 4.79 mm Hg. The average increase in IOP for eyes with glaucoma treated with Ranibizumab was 9 mm Hg and without glaucoma was 5.7 mm Hg. The patients with glaucoma had a greater average increase in IOP than those without glaucoma, whether treated with Bevacizumab or Ranibizumab. The increase was not statistically significant.
In our study we found a statistically significant increase in IOP after injections in all patients at the 95% confidence level (P=< .05). However, the increase was limited and did not exceed 30 mm Hg. Our findings suggest that the injection of 0.05 ml of Bevacizumab or Ranibizumab is not likely to cause a severe elevation of IOP in most patients, including those with glaucoma.
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