Abstract
Purpose :
To evaluate the change in thickness of the retinal nerve fiber layer (RNFL) and retinal ganglion cell layer (RGCL) following intravitreal anti-vascular endothelial growth factor (anti-VEGF) in patients with bilateral glaucoma and to assess whether intravitreal anti-VEGF injections may hasten inner retinal layer thinning.
Methods :
We performed a retrospective chart evaluation of subjects with bilateral glaucoma who have had 3 or more unilateral intravitreal anti-VEGF injections for retinal diseases including retinal vein occlusions, diabetic macular edema and exudative macular degeneration. An initial search for coexisting single eye intravitreal injection and glaucoma yielded 499 charts. 115 charts were identified using CPT codes corresponding to a diagnosis of bilateral glaucoma and unilateral injections. Of those that qualified, we obtained and compared baseline inner retinal layer measurements RNFL and RGCL in the treated eye versus the contralateral eye at baseline and at follow up in the same patient via spectral domain-optical coherence tomography (SD-OCT). The RGCL average thickness in microns were segmented using three concentric circles of the EDTRS grid of 1-mm, 3-mm, and 6-mm diameter, respectively.
Results :
We analyzed sixteen eyes with bilateral glaucoma (N=16 eyes) with eight diagnosed with unilateral retinal diseases including retinal vein occlusion, exudative age-related macular degeneration (AMD), and diabetic macular edema. Baseline RNFL & RGCL thickness was the same in treated and fellow eye. The mean RNFL in the treated eye at baseline was 84.25 +/- 16.88 microns and was 93.00+/-19.89 microns at follow up. The mean RGCL central foveal thickness in the treated eye at baseline was 19.50 +/-10.4 microns and was 25.63+/- 19.03 microns at follow up. RNFL & RGCL thickness was overall unchanged from baseline to follow up. RNFL & RGCL thickness was also overall the same in treated and fellow eye at follow up.
Conclusions :
Our data demonstrates that there was overall no impact of a mean of 8 anti-VEGF injections in the thickness of RNFL & RGCL followed for up to 3 years and thus we conclude that short-term anti-VEGF may be safe in this population.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.