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Abstract #91377 Published in IGR 21-4
Rates of RNFL Thinning in Patients with Suspected or Confirmed Glaucoma Receiving Unilateral Intravitreal Injections for Exudative AMD
Swaminathan SS; Kunkler AL; Quan AV; Medert CM; Vanner EA; Feuer W; Chang TCAmerican Journal of Ophthalmology 2021; 226: 206-216
PURPOSE: To evaluate whether the rate of retinal nerve fiber layer (RNFL) thinning is faster in eyes receiving intravitreal injections compared to fellow uninjected eyes among patients with suspected or confirmed glaucoma and exudative age-related macular degeneration (AMD). DESIGN: Retrospective comparative cohort study. METHODS: Patients diagnosed with unilateral exudative AMD and confirmed or suspected glaucoma in both eyes receiving unilateral intravitreal injections were identified. Those with ≥3 RNFL optical coherence tomography scans and ≥6 injections were included in the study. Rates of RNFL thinning in the injected eye versus the uninjected eye were estimated using linear mixed models. Main outcome measure was the difference in rate of RNFL thinning in the injected versus fellow uninjected eye. The effects of post-injection IOP elevation, injection frequency, and number of injections were also evaluated. RESULTS: A total of 53 patients met the inclusion criteria, receiving 26.4±15.9 intravitreal injections. The average rate of RNFL thinning in uninjected eyes was -0.620μm/year (p=0.029). Injected eyes had an additional incremental loss of -0.385μm/year but this value was not statistically significant (95% CI: -1.147 to 0.379μm/year; p=0.324). Subgroup analysis with only glaucoma patients (n=33) also demonstrated a non-significant effect of injections (-0.568μm/year; 95% CI: -1.454 to 0.319μm/year; p=0.212). Post-injection IOP elevation, injection frequency, and total number of injections were not associated with faster RNFL loss. CONCLUSIONS: Among exudative AMD patients with glaucoma or suspected of glaucoma, the rate of RNFL thinning in eyes receiving intravitreal injections did not significantly differ from that of fellow uninjected eyes.
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL. Electronic address: sswaminathan@miami.edu.
Full articleClassification:
11.15 Other drugs in relation to glaucoma (Part of: 11 Medical treatment)
6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
2.13 Retina and retinal nerve fibre layer (Part of: 2 Anatomical structures in glaucoma)