advertisement
Abstract #19922 Published in IGR 9-4
Short-term intraocular pressure changes after intravitreal injection of bevacizumab
Hollands H; Wong J; Bruen R; Campbell RJ; Sharma S; Gale JCanadian Journal of Ophthalmology 2007; 42: 807-811
BACKGROUND: This study examines the changes in short-term intraocular pressure (IOP) in patients receiving intravitreally administered bevacizumab. A prospective series of consecutive patients undergoing injection of intravitreal bevacizumab was investigated. METHODS: All patients received bevacizumab (0.05 cc) injected intravitreally in a standard fashion. IOP was measured at baseline, two, five, and 30 minutes after injection by one of two observers using Goldman applanation tonometry. An intraobserver study was done to assess agreement in IOP measurements. RESULTS: We accrued 104 patients with a mean age of 76 years: 58% were female, and 42% were male. Most patients (85%) were being treated for neovascular age-related macular degeneration. The mean IOP values at baseline, 2, 5, and 30 minutes after injection were 14.0 (95% confidence interval [CI] 13.4-14.7) mmHg, 36.1 (95% CI 33.5-38.6) mmHg, 25.7 (95% CI 23.8-27.5) mmHg, and 15.5 (95% CI 12.4-16.51) mmHg, respectively. Three patients (2.9%) had an IOP of 25 mmHg or higher at 30 minutes. IOP normalized within two hours without medical therapy in two of these patients, and one patient required a one-week course of glaucoma medication. Regression analysis showed a trend towards phakic patients having higher IOP at 30 minutes (odds ratio = 3.2; p = 0.089). INTERPRETATION: Intravitreal injection of bevacizumab is safe with respect to short-term IOP changes, as almost all patients' IOP returned to a safe range (< 25 mmHg) within 30 minutes. Elevated IOP at 30 minutes after injection does occur, rarely, thus clinicians should consider checking IOP after injection as a precaution. Transient extreme IOP elevations occur in a significant percentage of patients, but the consequences of these events are unknown.
Classification:
6.1.3 Factors affecting IOP (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)