Prolonged IOP monitoring for normalization after intravitreal injections may be unnecessary on the day of injection

Researchers retrospectively reviewed 213 consecutive injections (including ranibizumab, bevacizumab, pegaptanib and triamcinolone acetonide) in 112 patients, including 20 patients with glaucoma. Pressures were measured before injection, immediately after and at five-minute intervals until IOP was less than 30 mm Hg. Normalized IOP was achieved in all patients within 30 minutes. The authors conclude that after hand movement vision, optic nerve perfusion and lack of intraocular complications are verified, most patients don't require prolonged IOP monitoring. But they suggest cautious monitoring in cases in which more than 0.05 ml is injected with a small-bore needle or no reflux is seen after injection with a larger-bore needle, or in patients with a history of glaucoma, as these cases have a higher incidence of significant pressure spike.