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T. Evans, L. Wu; Short-Term Changes of Intraocular Pressure After an Intravitreal Injection of 2.5 mg (0.1 ml) of Bevacizumab (Avastin ®). Invest. Ophthalmol. Vis. Sci. 2007;48(13):3947.
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To report the short-term changes of intraocular pressure after an intravitreal injection of 2.5 mg (0.1 ml) of bevacizumab (Avastin ®) for the treatment of multiple retinal diseases.
Prospective case series of 64 intravitreal injections of 2.5 mg (0.1 ml) of bevacizumab in 51 eyes of 43 patients. The intraocular pressure (IOP) was measured with a Goldmann tonometer at baseline, 30 minutes and one day after injection in all of the cases. In 49 injections an additional IOP measurement was taken immediately after the injection.
At baseline, mean IOP was 16.36 ± 3.71 mm Hg with a range of 10 to 30 mm Hg. IOP rose to 52.71 ± 19.35 mm Hg (n=49, range of 16 to 76 mm Hg, p< 0.0001) immediately after the injection. Thirty minutes later, IOP was also significantly higher than baseline with a mean of 19.78 ± 7.99 mm Hg (range of 10 to 64 mm Hg, p<0.0001). IOP normalized 24 hours later to 15.46 ± 3.79 mm Hg (range of 10 to 34 mm Hg, p=0.1302). Only one patient required paracentesis, presenting an IOP of 64 mm Hg at the 30-minute follow-up, this patient had underlying neovascular glaucoma and the baseline IOP was 30 mm Hg. Three patients had an IOP higher than 21 mm Hg one day after the intravitreal bevacizumab, in one patient was secondary to neovascular glaucoma and one patient secondary to chronic use of topical steroids in which antiglaucoma topical treatment was required.
An intravitreal injection of 2.5 mg (0.1 ml) of bevacizumab seems to cause a transient elevation of IOP that tends to normalize 24 hours later. Caution must be taken in patients with advanced glaucomatous optic disc damage.
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