Immediate intraocular pressure changes following intravitreal injections of triamcinolone, pegaptanib, and bevacizumab

Abstract

Purpose To assess the intraocular pressure (IOP) changes, within the first 30 min after intravitreal injection of 0.1 ml (4 mg) triamcinolone, 0.09 ml (0.3 mg) pegaptanib, and 0.05 ml (1.25 mg) bevacizumab. Methods Records of patients who received intravitreal triamcinolone, pegaptanib, and bevacizumab and who had their IOP measured post-injection were reviewed. Results A total of 212 injections were performed (76 bevacizumab in 63 patients, 42 triamcinolone in 41 patients, 94 pegaptanib in 74 patients). At 10 min, over 87% of eyes receiving each drug had an IOP of less than 35 mmHg. Three of the 42 eyes receiving intravitreal triamcinolone were treated with IOP-lowering drops for pressures of 44, 46, and 60 mmHg. No patients treated with intravitreal bevacizumab or pegaptanib received IOP-lowering drops. The number of eyes in each injection group that had an IOP rise 410 mmHg within 30 min after injection was 27.6% of eyes receiving bevacizumab, 33.3% of eyes receiving triamcinolone, and 36.2% of eyes receiving pegaptanib. At 10 min, eyes with glaucoma were less likely to have an IOPo35 mmHg, but this difference became less marked with time. Conclusion In our series, most patients receiving intravitreal injections did not require IOP-lowering drops after injection, and none required a paracentesis.

Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature

“…29 Intraocular pressure elevation Acute rise of intraocular pressure (IOP) after intravitreal injection is injectionprocedure-related and lasts a few hours at most. 30,31 Recent studies, however, have reported a significant number of intravitreal anti-VEGF injections is associated with an increased risk for IOP elevation. 32,33 Patients with pre-existing glaucoma have higher rates of IOP elevation compared with those without pre-existing glaucoma.…”

Anterior segment changes on ultrasound biomicroscopy after intravitreal anti vascular endothelial growth factor injection

“…Bakri et al 8 compared IOP elevation after intravitreal injection of 0.3 mg Pegaptanib, 4 mg Triamcinolone and 1.25 mg Bevacizumab. Review of patient records reported that approximately 87% of eyes administered each drug recorded an IOP of less than 35 mmHg 10 min after injection.…”

“…[4][5][6][7][8][9][10] It was our assessment that some of the previously used techniques used to assess the rise in IOP and anterior segment anatomy, in these reports, were not the ideal techniques that could have been used. We aimed to further clarify the effect of intravitreal injection of anti VEGF agents upon intraocular pressure (IOP) and anterior chamber structure using a previously validated technique of Ultrasound biomicroscopy (UBM).…”

Alterations in intraocular pressure and ocular axial length after intravitreal Anti-VEGF injection

“…Bu yan etkilerden biri de ani GİB artışıdır. Artmış vitreus volümüne bağlı olarak enjeksiyondan hemen sonra GİB artışı beklenen bir durum olup çeşitli çalışmalarda geçici veya kalıcı özellikte olabileceği bildirilmiştir [5][6][7][8][9]. Daha önceki çalışmalara benzer şekilde bizim çalışmamızda da enjeksiyondan hemen sonra GİB'de anlamlı bir artış olduğu ve 24. saatte bu artışın normal değerlerine geri döndüğü izlendi.…”

“…Enjeksiyon ile ilgili (uygulanan enjeksiyon volümü, ve enjeksiyon sonrası reflü) ve göz ile ilgili (aksiel uzunluk, skleral rijidite, vitreus yapısı) faktörlere bağlı olmak üzere neredeyse tüm intravitreal enjeksiyonlardan sonra ortaya çıkan bir yan etki de ani göziçi basıncı (GİB) artışıdır [5][6][7][8][9]. Enjeksiyon sonrası ani GİB artışı ve oküler aksiyel uzunluk (AU) değişikliği ile ilgili çok sayıda çalışma bulunmasına karşın lensin, glokom mevcudiyetinin ve daha önceden enjeksiyon uygulanmış olmanın bu değişiklikler üzerindeki etkisini ortaya koyan bir çalışma bulunmamaktadır [6,10,11].…”