Abstract
Purpose :
Since the advent of anti-VEGF therapy, many reports of associated elevated intraocular pressure (IOP) have come to light. It is known that race has an important role in patient care where African American (AA) patients are at higher risk of reaching adverse glaucomatous endpoints more frequently. However, the literature lacks race-based studies regarding anti-VEGF therapy and incidence of elevated IOP. The aim of this study is to compare the incidence of elevated IOP following anti-VEGF therapy between AA and Caucasian patients as well as evaluate for possible risk factors.
Methods :
This is a retrospective study of adult patients treated with intravitreal Bevacizumab injections (IVI) at two tertiary referral centers and two Veteran Affairs clinics over the past decade. Subjects were included if they were >18 y.o. with a minimum of two years of follow up after the first IVI. Exclusion criteria were current or history of intravitreal steroid or topical steroid therapy and neovascular glaucoma. Subjects were categorized into three groups: group 1 were subjects receiving IVI with no previous diagnosis of ocular hypertension (OHTN) or glaucoma, group 2 were subjects receiving IVI with pre-existing diagnosis of OHTN/glaucoma, and the control group were subjects who did not receive IVI. Data collected included race, age, gender, indication of IVI, elevation of IOP above baseline (≥20%, ≥21mmHg, ≥25mmHg), months until first IOP elevation, and phakic status.
Results :
There was a statistically significant association between incidence of IOP elevation and IVI whereby our study showed that after about 5 IVI, patients were found to have a higher incidence of elevated IOP. There was no statistical significance between Caucasian and AA subjects receiving IVI. The elevated IOP occurred at an average of about 6-7 months following the first IVI in both groups. Furthermore, we found that there was no statistically significant difference based on indication for IVI, phakic status, gender or age.
Conclusions :
This study confirmed that there is a statistically significant relationship between anti-VEGF therapy and incidence of elevated IOP. We found that this relationship was not significant based on history of glaucoma/OHTN, race, indication, gender, age, and phakic status. These results further reinforce the importance of monitoring the IOP of patients receiving anti-VEGF therapy and contribute to patient-centered care.
This is a 2021 ARVO Annual Meeting abstract.