PT  - JOURNAL ARTICLE
AU  - Travis J Good
AU  - Alan E Kimura
AU  - Naresh Mandava
AU  - Malik Y Kahook
TI  - Sustained elevation of intraocular pressure after intravitreal injections of anti-VEGF agents
AID  - 10.1136/bjo.2010.180729
DP  - 2011 Aug 01
TA  - British Journal of Ophthalmology
PG  - 1111--1114
VI  - 95
IP  - 8
4099  - http://bjo.bmj.com/content/95/8/1111.short
4100  - http://bjo.bmj.com/content/95/8/1111.full
SO  - Br J Ophthalmol2011 Aug 01; 95
AB  - Aims To report the rate of intraocular pressure (IOP) elevation associated with repeated intravitreal injections of antivascular endothelial growth factor (VEGF) agents and to determine if a pre-existing diagnosis of glaucoma is a risk factor for this phenomenon.Methods The charts of 215 eyes undergoing intravitreal injection with anti-VEGF agents for wet age-related macular degeneration (AMD) were retrospectively examined with respect to frequency of injections, number of injections and changes in IOP. Data were analysed independently for two groups (1) pre-existing glaucoma and (2) no history of glaucoma.Results Of the 215 eyes receiving injections with bevacizumab and/or ranibizumab, 6% (n=13) had sustained IOP elevation requiring medical or laser interventions. Of the eyes receiving only bevacizumab, 9.9% (10/101) had sustained elevated IOP, while 3.1% (3/96) of eyes receiving only ranibizumab experienced increases (p=0.049). Patients with pre-existing glaucoma experienced higher rates of elevated IOP when compared with patients without pre-existing glaucoma (33% vs 3.1% respectively; p<0.001). The glaucoma subgroup had a lower median number of injections (6; interquartile range 5–10) compared with the non-glaucoma group (9.5; interquartile range 6–13.7; p=0.031).Conclusions The incidence of sustained elevated IOP in patients receiving intravitreal anti-VEGF injections is significant. Additionally, these data suggest the possibility of a heightened risk for further elevation of IOP in patients with pre-existing glaucoma who receive either bevacizumab or ranibizumab. Prospective studies are needed to verify these results and better understand the implications of these findings.