Short-term Effect of Intravitreal Injection of Ranibizumab (Lucentis) on Intraocular Pressure

Gismondi, Maurizio; Salati, Carlo; Salvetat, Maria Letizia; Zeppieri, Marco; Brusini, Paolo

doi:10.1097/ijg.0b013e31819c4893

Cited by 110 publications

(89 citation statements)

References 25 publications

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“…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.…”

Section: Methodsmentioning

confidence: 99%

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

Falavarjani

Nguyen

2013

Eye

737

505

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Intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents is increasingly used for the treatment of a wide variety of retinal diseases, including age-related macular degeneration, diabetic retinopathy and retinal vascular occlusions, and retinopathy of prematurity. Despite encouraging results in halting the disease and improving the vision, intravitreal injection of anti-VEGF agents may be associated with systemic adverse events and devastating ocular complications. In this review, we provide an overview of safety data for intravitreal injection of common anti-VEGF agents.

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Section: Methodsmentioning

confidence: 99%

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

Falavarjani

Nguyen

2013

Eye

737

505

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“…In order to investigate the immediate short-term effects of anti-VEGF injection on IOP, Gismondi et al [9] performed a prospective study of 54 eyes with intravitreal ranibizumab. In that study, the IOP was measured immediately before as well as 5 s and 5, 10, 15, 30 and 60 min and 1 day after injection.…”

Section: Introductionmentioning

confidence: 99%

Intraocular Pressure in Eyes Receiving Intravitreal Antivascular Endothelial Growth Factor Injections

et al. 2015

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between pre-and postoperative measurements (p < 0.05). Subconjunctival reflux was recorded in 11.3%, and in this subgroup the IOP at 5 min and at 1 h was lower than preoperative IOP (p < 0.05). Conclusions: More than one third of the eyes achieved IOPs >30 mm Hg 5 min after injection. Subconjunctival reflux contributed to a lower mean postoperative IOP (p < 0.05). Considerations for the management include prophylactic IOP lowering with medical therapy and/or preinjection ocular decompression for patients with a history of glaucoma or ocular hypertension and switching to an as-needed injection protocol in patients suffering a marked IOP rise in previous injections.

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“…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.…”

Section: Discussionunclassified

“…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].…”

Section: Introductionunclassified

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

Tufan¹,

Kara²,

Arıkan³

et al. 2015

Journal of Clinical and Experimental Investigations

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Objective: To evaluate the effect of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection on intraocular pressure (IOP) and ocular axial length (AL).Methods: A prospective series of consecutive patients undergoing injection of intravitreal bevacizumab or ranibizumab in our clinic was investigated. IOP was measured with Tono-Pen and ocular AL with ultrasound biometry before (IOP0, AL0) and about 1 min (IOP1, AL1) and 24 hours (IOP2, AL2) after intravitreal injection. Logistic regression analysis was used to investigate factors (lens status, presence of glaucoma and previous intravitreal injection) associated with increased IOP and AL. Results:We recruited 96 patients with a mean age of 66.7±12 years, 53 (55%) men and 43 (45%) women. One minute after the injection (IOP1), mean IOP increased from 15.2±3.5 mmHg (IOP0) to 22.2±8.6 mmHg (p<0.001). 24 hours after the injection, IOP decreased a mean level of 14.7±3.6 mmHg (IOP0 vs. IOP2, p˃0.05). Mean AL0, AL1 and AL2 values were 23.1± 0.82 mm, 23.25± 0.81 mm and 23± 0.8 mm, respectively. AL elongation was statistically significant just after injection (AL0 vs. AL1, p˂0.001). 24 hours after AL values were dropped below the baseline values (AL0 vs. AL2 p=0.04). Regression analysis showed a trend towards pseudophakic patients having higher IOP and AL at one minute. It was also observed that having previous intravitreal injections cause higher IOP elevation. Yöntemler: Kliniğimizde intravitreal bevacizumab veya ranibizumab enjeksiyonu uygulanan hastalar prospektif olarak değerlendirildi. GİB, Tono-Pen kullanılarak ve oküler AU, ultrason biyometri kullanılarak, enjeksiyondan önce (GİB0, AU0), enjeksiyondan 1 dakika (GİB1, AU1) ve 24 saat (GİB2, AU2) sonra ölçüldü. Artmış GİB ve AU ile ilişkili faktörler lojistik regresyon analizi kullanılarak incelendi. Bulgular:Ortalama yaş 66,7±12 olup 53'ü (%55) erkek ve 43'ü (%45) kadın olmak üzere toplam 96 hasta değerlen-dirildi. GİB0'ın 15,2±3,5 mmHg'dan, 22,2±8,6 mmHg'ya (GİB1) yükseldiği görülmüştür (p<0,001). Enjeksiyondan 24 saat sonra ortalama GİB 14,7±3,6 mmHg'ya düştü (GİB0 vs GİB2, p˃0,05). Ortalama AU0, AU1 ve AU2 değerleri sırasıyla 23,1± 0,82, 23,25± 0,81 ve 23± 0,81 mm idi. Enjeksiyondan hemen sonraki AL'deki artış istatistiksel olarak anlamlıydı (AU0 vs AU1, p<0,001). 24. saatte AL'nin başlangıç değerinin de altında bir değere düştüğü izlendi (AU0 vs AU2 p=0,04). Regresyon analizinde psö-dofakik hastalarda GİB ve AU artışına bir eğilim olduğu izlendi. Ayrıca daha önceden intravitreal enjeksiyon yapıl-mış olmanın da daha yüksek GİB artışına neden olduğu görüldü. Sonuçlar:İntravitreal anti-VEGF enjeksiyonları geçici GİB ve AU artışına neden olabilirler. Klinisyenler, intravitreal enjeksiyonlardan sonra önlem olarak GİB'i kontrol etmelidirler. İntravitreal enjeksiyonlardan sonraki biyometrik değişikliklerin anlaşılabilmesi için ileri araştırmalar gerekmektedir.Anahtar kelimeler: İntravitreal enjeksiyon, intraoküler basınç, oküler aksiyel uzunluk.

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Short-term Effect of Intravitreal Injection of Ranibizumab (Lucentis) on Intraocular Pressure

Abstract: IVIL causes a considerable short-term transient rise in IOP. The IOP increase after IVIL can be statistically significant at 0 to 30 minutes after injection in both phakic and pseudophakic eyes, and tends to be greater in shorter eyes.

Cited by 110 publications

References 25 publications

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

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

Intraocular Pressure in Eyes Receiving Intravitreal Antivascular Endothelial Growth Factor Injections

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

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