July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
A randomised clinical trial of slow versus fast intravitreal injection of ranibizumab (Lucentis®) and its impact on intraocular pressure (the Speed IOP Study)
Author Affiliations & Notes
  • Samantha Fraser-Bell
    University of Sydney, Sydney, New South Wales, Australia
    Sydney Eye Hospital, Chatswood, New South Wales, Australia
  • Sophia Zagora
    Sydney Eye Hospital, Chatswood, New South Wales, Australia
  • Hemal Mehta
    Sydney Eye Hospital, Chatswood, New South Wales, Australia
  • Anna Campain
    University of Sydney, Sydney, New South Wales, Australia
  • Hon Seng Wong
    Sydney Eye Hospital, Chatswood, New South Wales, Australia
  • Yeung Aaron
    Sydney Eye Hospital, Chatswood, New South Wales, Australia
  • Mark C Gillies
    Sydney Eye Hospital, Chatswood, New South Wales, Australia
  • Footnotes
    Commercial Relationships   Samantha Fraser-Bell, None; Sophia Zagora, None; Hemal Mehta, None; Anna Campain, None; Hon Seng Wong, None; Yeung Aaron, None; Mark Gillies, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 79. doi:https://doi.org/
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      Samantha Fraser-Bell, Sophia Zagora, Hemal Mehta, Anna Campain, Hon Seng Wong, Yeung Aaron, Mark C Gillies; A randomised clinical trial of slow versus fast intravitreal injection of ranibizumab (Lucentis®) and its impact on intraocular pressure (the Speed IOP Study). Invest. Ophthalmol. Vis. Sci. 2019;60(9):79. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess the impact of fast versus slow intravitreal injection of Lucentis® (ranibizumab) on immediate post-injection intraocular pressure (IOP) elevation.

Methods : This was a prospective, randomised, crossover, single masked clinical trial.

The study included 68 eyes of 68 patients being treated with ranibizumab (RBZ) for neovascular age-related macular degeneration (nAMD) randomly assigned to 2 groups (34 eyes in each). One group received intravitreal RBZ by a fast injection technique (in ≤ 1 second (s)) followed by a slower injection technique (over 3-4s) for their next visit's injection. The other group received RBZ by the slower injection technique first followed by the fast injection. Presence of post-injection reflux was documented.

Goldmann applanation tonometry was used to measure IOP just prior to the injection and 2 and 15 minutes (mins) post-injection. The primary outcome was mean IOP elevation 2 mins after injection using the fast and the slow injection techniques. Secondary outcomes included: mean IOP elevation 15 mins post-injection between the groups, effect of lens status or reflux on post-injection IOP elevation, and any adverse events associated with the intravitreal injection techniques.

Results : Of the 68 eyes enrolled, 64 completed the study. Injection speed had no significant impact on immediate post injection rise in IOP with the mean IOP elevation from baseline to 2 minutes being 18.0mmHg after slow injection and 17.9mmHg after fast injection of RBZ (P=0.93). At 15 minutes (mins), mean IOP elevation was 5.9mmHg vs 6.3mmHg after slow vs fast injection respectively (P=0.73). In the 41 eyes (64%) with reflux post injection, mean IOP elevation at 2mins was 9.7mmHg compared to 21.6mmHg in eyes without reflux (P<0.001). Lens status had no effect in degree if IOP elevation (P=0.12).

Conclusions : Intravitreal injection speed (fast versus slow) and lens status had no significant effect on immediate IOP elevation following intravitreal injections. Eyes with post-injection reflux had significantly less IOP elevation immediately post-injection.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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