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Abstract #51022 Published in IGR 14-3
Efficacy of prophylactic treatment of intraocular pressure spikes due to intravitreal injections
El Chehab H; Le Corre A; Giraud JM; Ract-Madoux G; Swalduz B; Dot CJournal Français d'Ophtalmologie 2012; 35: 614-621
PURPOSE: The purpose of this study was to evaluate intraocular pressure increase after intravitreal injections (IVIs) and the effect of prophylactic pressure-lowering medications. METHODS: A prospective study of 210 anti-vascular endothelial growth factor (VEGF) IVI (0.05 mL of bevacizumab or ranibizumab), that were divided into five groups, group 1: no intraocular pressure (IOP)-lowering medication (n=50); group 2: apraclonidine 1 % one drop 2 hours prior to IVI (n=50); group 3: acetazolamide 250 mg 2 hours prior (n=50); group 4: fixed combination brimonidine+timolol (n=30); group 5: fixed combination dorzolamide+timolol (n=30). IOP was measured before, immediately after (T1), 15 min after (T15) and 45 min after (T45) the IVI using a Perkins tonometer. RESULTS: The mean IOP peak in group 1 was 46.4 ± 4.8 mmHg at T1, 21.7 ± 5.7 mmHg at T15 and 15.4 ± 4.3 mmHg at T45. Apraclonidine 1 % and the fixed combinations produced a significant reduction of IOP at every time point, of around 9 mmHg at T1. The reduction in IOP obtained with acetazolamide was not significant versus group 1 at T1 (-1.6 mmHg, P=0.12), but became significant at T15 and T45 (respectively, P=0.011 and P=0.015). CONCLUSIONS: IOP spikes are high but transient following IVI. Acetazolamide proved to be ineffective in preventing this spike. Topical medications, however, produced a significant reduction in IOP spike as well as in the duration of the increased pressure, with no significant difference between fixed combinations and 1 % apraclonidine at T1. It would seem advisable to prevent this IOP spike in the case of repeated injections, particularly in patients with glaucoma.
Service d'ophtalmologie, HIA Desgenettes, 108, boulevard Pinel, 69003 Lyon, France.
Full articleClassification:
11.15 Other drugs in relation to glaucoma (Part of: 11 Medical treatment)