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Abstract #53652 Published in IGR 15-2

Comparison of Acetazolamide, Brimonidine, and Anterior Chamber Paracentesis for Ocular Hypertension Control After Initial Intravitreal Bevacizumab Injection: A Randomized Clinical Trial

Katayama BY; Bonini-Filho MA; Messias AM; Paula JS; Martin LF; Costa R; Jorge R
Journal of Glaucoma 2014; 23: 461-463

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PURPOSE: To evaluate the effects of oral acetazolamide (ACZ), anterior chamber paracentesis (ACP), or topical brimonidine tartrate (BT) to reduce intraocular pressure (IOP) elevation after intravitreal bevacizumab injection (IVBI). PATIENTS AND METHODS: A total of 56 patients scheduled for IVBI (1.5 mg/0.06 mL) were randomly assigned to a pretreatment with ACZ (14 eyes), BT (14 eyes), as well as an immediately after ACP (14 eyes), or no treatment (control group-CG) (14 eyes). IOP was measured 90 minutes before injection (baseline), just before injection, and at 3, 10, 20, and 30 minutes after the procedure. RESULTS: IOP was increased at 3 minutes after injection in CG, 20.9±2.1 (mean±SE intraindividual change in mm Hg); BT, 15.5±2.3; ACZ, 13.7±1.7; but not in ACP, 0.3±1.2 (P<0.0001). At 30 minutes after injections, IOP difference to baseline was not significantly different in groups BT, 0.0±0.7; ACZ, -3.2±0.8; and ACP, -2.5±3.9, but was kept higher in the CG, 4.0±4.3 (P<0.0001). CONCLUSIONS: ACP prevents IOP elevation after IVBI, whereas ACZ and BT caused a faster return to baseline than untreated nonglaucomatous eyes. Further studies with larger number of subjects, including glaucomatous patients, and the use of other topical glaucoma medications are warranted to establish a standard recommendation.

*Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto USP, Ribeirão Preto-SP, Brazil †Macular Imaging and Treatment Division, Hospital de Olhos Araraquara, Araraquara-SP, Brazil.

Full article

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Classification:

9.4.5.5 Other (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous)
11.15 Other drugs in relation to glaucoma (Part of: 11 Medical treatment)
11.5.2 Topical (Part of: 11 Medical treatment > 11.5 Carbonic anhydrase inhibitors)
11.3.3 Apraclonidine, brimonidine (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)

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