Long-term effects of multiple intravitreal antivascular endothelial growth factor injections on intraocular pressure

Am J Ophthalmol. 2014 Jun;157(6):1266-1271.e1. doi: 10.1016/j.ajo.2014.02.035. Epub 2014 Feb 18.

Abstract

Purpose: To evaluate long-term effects of multiple intravitreal antivascular endothelial growth factor (VEGF) injections on intraocular pressure (IOP) in eyes with neovascular age-related macular degeneration (AMD) or retinal vein occlusion (RVO).

Design: Retrospective cohort study.

Methods: This study enrolled patients who underwent multiple (more than 3) intravitreal anti-VEGF injections and who were followed for more than 12 months after their last injection. IOP elevation was defined as an increase of 5 mm Hg over the baseline measurement on 2 consecutive visits. The frequency of IOP elevation was determined. A hazard ratio of each putative risk factor for IOP elevation was calculated using the Cox proportional hazard model for all participants, incorporating underlying disease as a covariate, as well as for each cohort.

Results: Included in the analysis were 629 eyes with neovascular AMD and 95 eyes with RVO. Twenty eyes with neovascular AMD (3.0%) and 7 eyes with RVO (7.4%) experienced IOP elevation after multiple anti-VEGF injections, with an overall incidence of 3.7%. In the Cox proportional hazard analysis of total participants, a diagnosis of RVO (3.424, P = 0.005), a history of glaucoma (8.441, P = 0.001), and low baseline IOP (0.865, P = 0.040) were all significant risk factors for IOP elevation after multiple anti-VEGF injections.

Conclusion: A history of multiple intravitreal anti-VEGF injections was not a significant risk factor for IOP elevation in our study. IOP elevation was more common in eyes with RVO than with AMD after anti-VEGF injection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / administration & dosage
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Bevacizumab
  • Female
  • Follow-Up Studies
  • Humans
  • Intraocular Pressure / drug effects*
  • Intravitreal Injections
  • Male
  • Ranibizumab
  • Retinal Vein Occlusion / drug therapy*
  • Retreatment
  • Retrospective Studies
  • Tonometry, Ocular
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Visual Acuity
  • Wet Macular Degeneration / drug therapy*

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Ranibizumab