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Abstract #26939 Published in IGR 12-4
Effect of Prophylactic Intraocular Pressure–Lowering Medication on Intraocular Pressure Spikes After Intravitreal Injections
MPC Frenkel; SA Haji; REP FrenkelArchives of Ophthalmology 2010; 128: 1523-1527
See also comment(s) by Jost Jonas •
Objective: To determine if prophylactic use of intraocular pressure (IOP)–lowering medication is effective in reducing the IOP spikes after intravitreal injections of pegaptanib, bevacizumab, and ranibizumab. Methods: Seventy-one patients with exudative age-related macular degeneration received intravitreal injections of 1 of 3 anti–vascular endothelial growth factor medications: 30 patients received pegaptanib (0.09 mL), 47 patients received bevacizumab (0.05 mL), and 42 patients received ranibizumab (0.05 mL). Intraocular pressure–lowering medication, 1 hour prior to the injection, was used 63%, 74%, and 66% of the time in eyes that received pegaptanib, ranibizumab, and bevacizumab, respectively. Intraocular pressure was measured prior to injection, within 1 minute after injection, and every 5 to 10 minutes until the pressure was reduced to a safe level. Results: All 3 intravitreal injections caused significant initial IOP spikes (mean [SD] IOP of 38.5 [11.56] mm Hg in the pegaptanib group, 37.75 [8.36] mm Hg in the ranibizumab group, and 34.88 [10.45] mm Hg in the bevacizumab group). The IOP reduced to less than 30 mm Hg in all 3 groups within 20 minutes. Prophylactic medication did not prevent postinjection IOP spikes. Patients with and without glaucoma showed a similar rate of IOP normalization over time in all 3 groups. Conclusion: Intraocular pressure spikes after intravitreal injection of pegaptanib, ranibizumab, and bevacizumab are common and in most cases transient. Routine prophylactic use of IOP-lowering medications is essentially ineffective in preventing IOP spikes after intravitreal injection of pegaptanib, ranibizumab, and bevacizumab and therefore not necessary before the injection.
Eye Research Foundation (Drs M. P. C. Frenkel, Haji, and R. E. P. Frenkel) and East Florida Eye Institute (Drs Haji and R. E. P. Frenkel), Stuart.
Classification:
11.15 Other drugs in relation to glaucoma (Part of: 11 Medical treatment)
6.1.3 Factors affecting IOP (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
