Characterization of Sustained Increases in Intraocular Pressure After Aflibercept in Prefilled and Vial Draw Syringes.

Abstract

Purpose : Several studies have found intravitreal anti-VEGF injections to be associated with chronic intraocular pressure (IOP) elevation. Furthermore, delivery of these injections with prefilled syringes (PFS) may be associated with higher rates of sustained IOP increases compared to vial draw delivery. The purpose of this study is to evaluate the effect of syringe type on the development of sustained increases in IOP among patients receiving aflibercept injections in a single tertiary care center.

Methods : A retrospective cohort study was completed on patients receiving aflibercept injections at the Cole Eye Institute from 2012-2022. Patients were grouped as either having received vial draw injections or prefilled syringe injections for aflibercept treatment. IOP measurements and number of subsequent injections were recorded for one year following treatment initiation. The primary outcome measure was sustained increase in intraocular pressure, defined as ≥5 mmHg above baseline for at least 4 weeks. Secondary outcome measures included development of ocular hypertension and glaucoma.

Results : Six of 305 total eyes (1.9%) developed sustained IOP increases throughout the study duration. No significant differences were observed with respect to prefilled versus vial draw syringe status on development of sustained IOP increases or ocular hypertension (1.6% vs 2.3%, p>0.05, 3.9% vs 9.5%, p>0.05 respectively).

Conclusions : This study finds an overall low incidence of sustained IOP increases in patients treated with aflibercept. Furthermore, syringe status was not found to be a relevant factor in sustained IOP increases. This study adds to existing literature challenging the associations between intravitreal injection and ocular pressure abnormalities.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.