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Persistent ocular hypertension following intravitreal injections of anti‐VEGF agents or dexamethasone intravitreal implant
Author(s) -
AGARD E,
ELCHEHAB H,
RUSSO A,
RACT MADOUX G,
SWALDUZ B,
DUSSART C,
DOT C
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.f008.x
Subject(s) - medicine , dexamethasone , ranibizumab , intraocular pressure , implant , bevacizumab , glaucoma , ophthalmology , ocular hypertension , diabetes mellitus , capsulotomy , surgery , intraocular lens , chemotherapy , endocrinology
Purpose To report the rate of intraocular pressure elevation following repeated intravitreal injections (IVI) of anti‐VEGF agents or dexamethasone intravitreal implant and to determine the risk factors. Methods A prospective study of 166 eyes undergoing IVI of ranibizumab (n=126), bevacizumab (n=19), or dexamethasone implant (n=12) was carried out. A total of 886 IVI were performed. The development of ocular hypertension (OHT) following these injections was investigated with respect to number of injections, pre‐existing glaucoma, diabetes and YAG capsulotomy. Results After a mean of 5.34 +/‐ 5.1 IVI (range, 1‐30), 8.4% (n=14) had IOP elevation above 25 mmHg and required medical treatment (3% of them peaked above 30mmHg).Patients with pre‐existing glaucoma experienced highter rates of OHT were compared to patients without pre‐existing glaucoma (21.7mmHg +/‐12.4 versus 17.23mmHg +/‐4.5, p=0.06). No significant difference was found in diabetes subgroup (n=40, p=0.32), nor in YAG capsulotomy subgroup (n=12, p=0.8) compared to the control group. The peak of IOP was significatively correlated with the total number of IVI (p=0.01, R=0.19).The mean highest IOP was 17.2mmHg in ranibizumab group, 18.8mmHg in bevacizumab group and 19.9mmHg in dexamethasone intravitreal implant. No difference was found between these molecule subgroups (Kruskal‐Wallis p=0.38). Conclusion Serial intravitreal injections may lead to persistent IOP elevations that require IOP lowering therapies. This risk is correlated with the number of injections and must be checked during the follow‐up. Pre‐existing glaucoma could be a risk factor but larger prospective studies are needed to verify these results.