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  • IOP After Anti-VEGF Injections

    By Jean Shaw
    Selected By: Andrew P. Schachat, MD
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    Journal Highlights

    Ophthalmology Retina, September 2020

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    Gabrielle et al. set out to assess the impact of anti-VEGF injections on intraocular pressure (IOP) in patients seen outside of clinical trials. They found that, in most eyes, mean IOP did not change significantly from base­line following intravitreal injections. However, a small proportion of eyes—particularly those with preexisting glaucoma—did experience clinically significant increases in IOP.

    For this retrospective study, the re­searchers analyzed data from the Fight Retina Blindness! Project on treatment-naive eyes that received injections of ra­nibizumab, aflibercept, or bevacizumab in routine clinical practice. Diseases treated included neovascular age-related macular degeneration, diabetic macular edema, and macular edema secondary to retinal vascular occlusion.

    The researchers identified 3,429 treatment-naive eyes of 3,032 patients. Participants had received at least three anti-VEGF injections and been followed up for at least 12 months; follow-up data extending to 24 months was avail­able on 62% of the patients. The pri­mary outcome measure was the mean change in IOP at 12 months. Second­ary outcomes measured at 12 and 24 months included mean change in IOP from baseline and the proportion of patients who had a clinically significant IOP increase. The latter was defined as an increase of at least 6 mm Hg to an IOP of more than 21 mm Hg.

    The overall mean change in IOP was –0.5 mm Hg at 12 months and –0.4 mm Hg at 24 months. Eyes that received aflibercept experienced a lower mean IOP change and fewer IOP eleva­tions at the 12- and 24-month marks (p ≤ 0.01 for each). A small subset of eyes experienced clinically significant rises in IOP; this affected 193 eyes (5.6%) at 12 months and 186 eyes (8.8%) at 24 months. Further evaluation indicat­ed that glaucomatous eyes were more likely to experience IOP elevations following intravitreal injections. (Also see related commentary by Matthew W. MacCumber, MD, PhD, in the same issue.)

    The original article can be found here.