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David Na, Sachin Kalarn, Ramya Swamy; Effects of anti-vascular endothelial growth factor agents on intraocular pressure. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1959.
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© ARVO (1962-2015); The Authors (2016-present)
The role of anti-Vascular Endothelial Growth Factors (VEGF) agents in the treatment of various vitreoretinal diseases is rapidly growing. In this study, we investigated the relationship of anti-VEGF injections and intraocular pressure (IOP) with the treatment of various vitreoretinal conditions and the use of various anti-VEGF agents.
We identified 80 patients that received intravitreal anti-VEGF injections in one eye from the University of Maryland database (2013-2018). Patient demographics, lens status, type of anti-VEGF agent, underlying retinal disease, total number of injections, IOP prior to injections, and time between first and last injection were collected. IOP data of the untreated eye was collected to serve as control. Independent sample, paired t-test, and analysis of variance was performed to test for significance between the collected data points and IOP.
Of the 80 total patients enrolled, 73 patients were identified that initially received treatment with a single anti-VEGF agent. 57.5% were females; 60% were African American. The average number of injections was 3.8±2.2 injections within a follow-up period of 7.1±7.9 months. There was no significant difference between the IOP of the treated eye and the control eye (μ=0.30±1.83mmHg; p=0.164). There was no significant IOP differences between bevacizumab and other agents (p=0.872). To increase statistical power, all 80 patients were included, which was inclusive for patients receiving injections of different anti-VEGF agents. The average number of injections increased to 5.7±5.6 injections within a follow-up period of 11.4±11.6 months. In this inclusive population, the IOP of the treated eye was 0.6 mmHg greater than the IOP of the control eye (p=0.016). When the IOP difference was stratified with sex, females had a greater IOP change than males (μ=1.59±0.80mmHg;95%CI=0-3.17; p=0.049). When the IOP difference was stratified with race, underlying retinal disease, and lens status, there were no significant differences.
There were statistically significant changes in IOP of the treated eye compared to the control eye, with an average of 6 injections over an 11-month follow-up period. However, this may be of little clinical significance (μ=0.6mmHg). Sex-related IOP changes were observed, where females may be more likely than males to develop sustained IOP elevations with repeat intravitreal anti-VEGF injections.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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