The Effects of Intravitreal Ranibizumab, Aflibercept or Dexamethasone Implant Injections on Intraocular Pressure Changes

Abstract

BackgroundThe aim of this study was to compare the alterations in intraocular pressure (IOP) values during the early postoperative period after intravitreal ranibizumab, aflibercept, or dexamethasone implant injections.Material/MethodsIn this retrospective study, a total of 188 patients were grouped into 3 groups: the ranibizumab group, the aflibercept group, and the dexamethasone group. Ocular axial length (AXL) and anterior chamber depth (ACD) were measured in the pre-injection period. IOP was measured just before the injection at 1 minute,10 minutes, 1 hour, 1 day, and 1 month after injection.ResultsThere was a transient peak in the ranibizumab group and the aflibercept group at 1 minute that started to decrease at 10 minutes and IOP values returned to preoperative values at approximately 1 hour. Similar alterations were also determined for the dexamethasone group with a lesser increase noted. In the correlation analysis, only alterations in IOP levels at 1 minute were negatively correlated with preoperative AXL values. There was not any correlation between preoperative AXL or ACD values and IOP alterations at any other time points.ConclusionsThere was a sudden, transient increase in IOP values after intravitreal ranibizumab or aflibercept injections; which return to normal values in a short time without requirement of any medical treatments. This transient peak was determined to be negatively correlated with the preoperative AXL.

Intraocular Pressure Elevation Following Intravitreal Anti-VEGF Injections: Short- and Long-term Considerations

“…Studies reporting risk factors are summarized in Table 2. 7,10,[37][38][39][40][41][42][43][44][45][46][47] For many of these factors, published studies can be found both to support and to contradict their effects on postinjection pressure. Factors related to the effect of increased volume in a closed space include axial length and lens status.…”

Efficacy and safety profile of intravitreal dexamethasone implant versus antivascular endothelial growth factor treatment in diabetic macular edema: a systematic review and meta-analysis

“…Aflibercept 15 69.4 N/A 3/12 7.6 0.28 411 2. Ozurdex + Aflibercept 15 66.2 N/A 4/11 8.2 0.19 411.4 Karakurt et al 20 Retrospective 2018 1 Not persisted DME 1. Ranibizumab 81 62.94 40/41 N/A N/A N/A N/A 2.…”

monitor mean changes in intraocular pressure following intravitreal injection of bevacizumab in exudative age related macular degeneration and proliferative diabetic retinopathy

“…Trehan et al, and Karakurt et al, found short term rise in the IOP, which did not show any influence on retinal blood flow and returned to baseline within 30 min to 1 hour following Intravitreal Anti-VEGF. 19,20 We enrolled 90 eyes of the patients in our study with baseline IOP 13.54 ± 2.1, which elevated to 32.89 ± 6.3 at 5 minutes following IVB and returned to baseline between 30 min to 1 hour. The significant determinants of IOP alterations following IVB are the method of application, amount of reflux, volume of fluid injected, axial length of the eyeball, posterior vitreous detachment, size of the needle, vitreous liquefaction and scleral thickness.…”