advertisement
Abstract #60780 Published in IGR 16-4
Repeated intravitreal anti-vascular endothelial growth factor injections can induce iatrogenic ocular hypertension, especially in patients with open-angle glaucoma
Agard E; Elchehab H; Ract-Madoux G; Russo A; Lagenaite C; Dot CCanadian Journal of Ophthalmology 2015; 50: 127-131
OBJECTIVE: To report the rate of intraocular pressure (IOP) elevation after repeated intravitreal injections (IVIs) of anti-vascular endothelial growth factor (anti-VEGF) agents and to determine the risk factors. METHODS: A total of 193 patients (217 eyes) undergoing ranibizumab (n = 196) or bevacizumab (n = 21) IVIs were prospectively examined. The incidence of ocular hypertension (OHT) after these injections was investigated with respect to the number of injections, pre-existing open-angle glaucoma, diabetes, YAG capsulotomy, age, and sex. RESULTS: A total of 1461 IVIs was performed. After a mean of 6.7 ± 7.1 IVIs (range, 1-49), 4.6% (n = 10) had IOP elevation more than 25 mm Hg and required medical treatment (1.4% of them spiked above 30 mm Hg). Patients with pre-existing glaucoma experienced higher prevalence of OHT (12.9%) and greater rates than the control group (19.6 ± 5.7 mm Hg vs 16.4 ± 3.9 mm Hg, p < 0.001). No significant difference was found in the diabetes subgroup (n = 66, p = 0.62) or in the YAG capsulotomy subgroup (n = 24, p = 0.51) compared with the control group. The IOP peak was significantly correlated with the total number of IVIs (p = 0.0002, r = 0.25). CONCLUSIONS: Serial IVIs may lead to persistent IOP elevation that requires IOP-lowering therapy. The risk is correlated with the number of injections and increases in the glaucoma population, and must be checked during follow-up.
Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France.
Full articleClassification:
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)
