Short-term intraocular pressure changes after intravitreal injection of bevacizumab

Hollands, Hussein; Wong, Jonathan; Bruen, R.; Campbell, Robert J.; Sharma, Sanjay; Gale, Jeffery

doi:10.3129/i07-172

Cited by 177 publications

(133 citation statements)

References 11 publications

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“…These authors postulated that the recurrent NAION may be related to impaired vascular autoregulation attributable to VEGF blockade or acute IOP elevation. 27 Concerning IOP elevation, the timing seems somewhat incongruous with this, as increases in IOP post-injection are typically transient, usually dissipating within 30 min, 28,29 which is much earlier than the recurrent NAION episodes reported.…”

Section: Discussionmentioning

confidence: 86%

Intravitreal bevacizumab for the treatment of nonarteritic anterior ischemic optic neuropathy: a prospective trial

Rootman

Gill

Margolin

2013

Eye

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Section: Discussionmentioning

confidence: 86%

Intravitreal bevacizumab for the treatment of nonarteritic anterior ischemic optic neuropathy: a prospective trial

Rootman

Gill

Margolin

2013

Eye

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“…5,6 Debate exists as to whether patients with glaucoma, a condition characterised by peripheral visual field loss and raised IOP, have a different pattern of pressure rise. 5,7,8 IOP spikes and sustained IOP elevation cause progression of glaucoma. Frenkel et al 9 studied prophylactic medication to prevent IOP rise in patients undergoing intravitreal therapy and concluded that they are essentially ineffective, but to the best of our knowledge no study has investigated prophylactic treatment in exclusively glaucoma or glaucoma suspect patients.…”

Section: Introductionmentioning

confidence: 99%

Short-term intraocular pressure trends following intravitreal ranibizumab injections for neovascular age-related macular degeneration—the role of oral acetazolamide in protecting glaucoma patients

Murray

Wood

Allgar

et al. 2014

Eye

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Purpose To determine the effect of oral acetazolamide on lowering the peak and duration of intraocular pressure (IOP) rise in glaucoma and glaucoma suspect patients, following intravitreal injection of ranibizumab for neovascular age-related macular degeneration. Methods The study was an open-label, parallel, randomised, controlled trial (EudraCT Number: 2010-023037-35). Twenty-four glaucoma or glaucoma suspect patients received either 500 mg acetazolamide or no treatment 60-90 min before 0.5 mg ranibizumab. The primary outcome measure was the difference in IOP immediately after injection (T0) and 5, 10, and 30 min following injection. ANCOVA was used to compare groups, adjusting for baseline IOP. The study was powered to detect a 9-mm Hg difference at T0. Results The IOP at T0 was 2.3 mm Hg higher in the non-treated group (mean 44.5 mm Hg, range (19-86 mm Hg)) compared with the treated group (mean 42.2 mm Hg, range (25-58 mm Hg)), but was not statistically significant after adjusting for baseline IOP (P ¼ 0.440). At 30 min, IOP was 4.9 mm Hg higher in the non-treated group (mean 20.6 mm Hg, range (11-46 mm Hg)) compared with the treated group (mean 15.7 mm Hg, range (8-21 mm Hg)). This was statistically significant after adjusting for baseline IOP (P ¼ 0.013). Conclusions Although the primary end points were not reached, 500 mg oral acetazolamide, 60-90 min before intravitreal injection, results in a statistically significant reduction in IOP at 3O min post injection. Prophylactic treatment may be considered as an option to minimise neuro-retinal rim damage in high-risk glaucoma patients who are most vulnerable to IOP spikes and undergoing repeated intravitreal injections of ranibizumab.

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“…Hollands ve ark. 21 0,05 ml bevacizumab enjeksiyonu sonrasında hastaların birçoğunda GİB'in otuzuncu dakikada güvenli kabul edilebilecek değerlere ulaştığını saptamışlar ve klinisyenlerin GİB takibi yapmayı, bir önlem olarak göz önünde bulundurması gerektiğini bildirmişlerdir. Kim ve ark.…”

Section: Discussionunclassified

İntravitreal Bevacizumab Uygulamasının Erken Dönem Göz İçi Basıncına Etkisi

Özçalışkan¹,

Yılmazbaş²,

Öztürk³

et al. 2014

tjo

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Amaç: İntravitreal 0,05 ml (1,25 mg) bevacizumab enjeksiyonu sonrası erken dönemde saptanan göz içi basıncı (GİB) değişikliklerinin değerlendirilmesi. Gereç ve Yöntem: Çalışma kapsamına intravitreal 0,05 ml bevacizumab enjeksiyonu uygulanan 57 hastanın 57 gözü dahil edildi. Enjeksiyondan hemen önce, enjeksiyondan bir dakika, 30 dakika ve bir saat sonra TonoPen ile ölçülen saptanan GİB değerleri not edildi. Göz içi basıncında zaman içinde gözlenen değişiklikler SPSS 15.0 programı kullanılarak değerlendirildi. Bulgular: Hastaların ortalama yaşı 62,8±11 yıl idi. Çalışma kapsamına alınan hastalar diyabetik retinopati (36 göz), retinal ven tıkanıklığı (10 göz), eksudatif yaşa bağlı makula dejenerasyonu (7 göz) ve kronik santral seröz retinopati tanısı almıştı. Enjeksiyondan önce ölçülen ortalama GİB değeri 17,91±3,7 mmHg idi. Enjeksiyon sonrası ortalama GİB birinci dakikada 34,58±13,5 mmHg; 30. dakikada 21,86±5,39 mmHg ve birinci saatte 20,64±5,77 mmHg düzeyindeydi. Enjeksiyon öncesi ölçülen GİB değerleri ile enjeksiyon sonrası belirlenen farklı zamanlarda ölçülen GİB değerleri karşılaştırıldığında istatistiksel olarak anlamı bir fark bulunduğu saptandı (p<0,05). Sonuç: İntravitreal 0,05 ml bevacizumab enjeksiyonundan hemen sonra GİB'de ani ve geçici bir yükselme olmaktadır. Göz içi basıncı kısa sürede medikal veya cerrahi tedavi gerekmesizin normal değerlerine ulaşmaktadır. ( Materials and Methods:The study included 57 eyes of 57 patients who had an intravitreal injection of 0.05 mL bevacizumab. The IOPs (measured by TonoPen) before the injection and one minute, 30 minutes, and one hour after the injection were recorded. The changes in IOP in time were evaluated by using the SPSS 15.0 programme. Results: The mean age of the patients was 62.8±11 years. The patients who received an 0.05 mL bevacizumab injection had diagnosis of diabetic retinopathy (36 eyes), retinal vein occlusion (10 eyes), exudative age-related macular degeneration (7 eyes), and chronic central serous retinopathy (4 eyes). Mean IOP was 17.91±3.7 mmHg before the injection. Mean IOP was 34.58±13.5 mmHg on first minute, 21.86±5.39 mmHg on 30 minutes, and 20.64±5.77 mm Hg one hour after the injection. The difference between the pre-injection IOPs and post-injection IOPs in different time periods was statistically significant (p<0.05). Conclusion: After intravitreal injection of 0.05 mL of bevacizumab, an acute and transient rise in IOP developed immediately. IOP normalizes without any medical or surgical treatment in short term. (Turk J Ophthalmol 2014; 44: 361-4)

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Short-term intraocular pressure changes after intravitreal injection of bevacizumab

Cited by 177 publications

References 11 publications

Intravitreal bevacizumab for the treatment of nonarteritic anterior ischemic optic neuropathy: a prospective trial

Intravitreal bevacizumab for the treatment of nonarteritic anterior ischemic optic neuropathy: a prospective trial

Short-term intraocular pressure trends following intravitreal ranibizumab injections for neovascular age-related macular degeneration—the role of oral acetazolamide in protecting glaucoma patients

İntravitreal Bevacizumab Uygulamasının Erken Dönem Göz İçi Basıncına Etkisi

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