A Prospective Study of Blood Pressure and Intraocular Pressure Changes in Hypertensive and Nonhypertensive Patients After Intravitreal Bevacizumab Injection

Lee, Kihwang; Yang, Hongseok; Lim, Hunsub; Lew, Ho Min

doi:10.1097/iae.0b013e3181b21056

Cited by 30 publications

(19 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It might be suggested that the measured BP in the CNV group was more influenced by the factors mentioned above, relative to that seen in the other groups, because it included fewer hypertensive patients. This hypothesis can be supported by an earlier study reported by Lee et al, 16 for which similar results were obtained from evaluating the changes in BP in patients with and without hypertension after intravitreal bevacizumab injection with the same population group. Regardless, the initial increase of BP at 30 min after injection reported in the CNV group might reflect the emotional stress associated with the procedure rather than adverse effects of anti-VEGF therapy, because the maximal serum concentration of bevacizumab after intravitreal injection is reached at post-operative day 8, according to an animal study.…”

Section: Discussionsupporting

confidence: 80%

“…1,3,4 Although many studies have investigated the elevation of IOP and BP after intravitreal bevacizumab, 12,13,15,16 none has evaluated its effects on BP in relation to the specific ocular pathology present. The mechanism by which inhibition of VEGF induces hypertension is unclear, but a recent study reported that endothelial dysfunction and capillary rarefaction are closely associated with the observed increase in BP.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Blood pressure changes after intravitreal bevacizumab in patients grouped by ocular pathology

Younghae

Lee

Cho

et al. 2010

Eye

View full text Add to dashboard Cite

Purpose We evaluated the effects of intravitreal injection of bevacizumab (Avastin; Novartis, Basel, Switzerland) on blood pressure (BP) in the context of ocular vascular pathology. Methods This study retrospectively examined 135 consecutive patients treated with intravitreal injections of 1.25 mg bevacizumab for retinal vascular disease; there were 61 cases of diabetic retinopathy, 30 of retinal vein occlusion, 35 of choroidal neo-vascularization (CNV), and 9 of other retinal vascular diseases. BP was measured before injection and at 30 min, 1 day, 1 week, 3 weeks, and thereafter monthly over a 6-month period. Results In the CNV group, 30-min postinjection systolic values were significantly higher than baseline, and systolic and diastolic values after 1 day, 1 week, and 3 weeks were significantly lower than before injection. No other pressure measurement differed significantly from baseline values in the other groups. Discussion Intravitreal bevacizumab injection is safe in terms of its effect on BP, regardless of ocular pathology.

show abstract

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Blood pressure changes after intravitreal bevacizumab in patients grouped by ocular pathology

Younghae

Lee

Cho

et al. 2010

Eye

View full text Add to dashboard Cite

show abstract

“…There are several contradictory papers in the literature pointing out the potential risk of an increase in blood pressure following injection with bevacizumab [25][26][27] . Lee et al [24] showed that IVB is safe in terms of effects on blood pressure after 6 months of follow-up. However, worsening hypertension as a result of IVB is one of the clinically relevant side effects that was observed in another study [27] .…”

Section: Discussionmentioning

confidence: 99%

Serum Concentration of Bevacizumab after Intravitreal Injection in Experimental Branch Retinal Vein Occlusion

Chuang

Wu²,

Yeung³

et al. 2010

Ophthalmic Res

View full text Add to dashboard Cite

Aim: To compare the serum concentration of bevacizumab after intravitreal injection of bevacizumab (IVB) in an experimental model of branch retinal vein occlusion (BRVO) with control injections in albino rats. Methods: BRVO was created in one eye of each of the 24 albino rats. Another 24 rats served as controls. The BRVO was generated by argon laser photothrombosis after intravenous injection with Rose Bengal. Three days later, IVB (5 µl) was administered to both BRVO and control eyes. The serum concentration of bevacizumab was examined at baseline, 6 h, 1 day, 3 days, 7 days, 14 days, and 28 days after IVB. Results: At baseline, no serum bevacizumab was detected in either group. The serum concentration of bevacizumab reached a peak concentration at 1 day with 5,020 ± 1,602 ng/ml in the BRVO group and 4,103 ± 1,790 ng/ml in the control group (p < 0.001). The concentration decreased subsequently on days 3, 7, 14 and 28. The serum concentration of bevacizumab was significantly higher in BRVO rats up to 28 days after IVB. Conclusions: The serum concentration of bevacizumab after IVB reached its peak on day 1 in both BRVO and control eyes. This value was significantly higher in BRVO rats than in control rats up to 28 days after intravitreal injection.

show abstract

“…This effect on the vascular tone may last for 3 weeks following intravitreal injections,54–56 but Lee et al found that only 30-minute systolic values were significantly higher than baseline blood pressure after bevacizumab injection 56. It is possible that this acute rise in blood pressure may be related to the stress of the intravitreal injection.…”

Section: Discussionmentioning

confidence: 99%

Insight into 144 patients with ocular vascular events during VEGF antagonist injections

Mansour

Shahin

Kofoed

et al. 2012

OPTH

View full text Add to dashboard Cite

AimTo record ocular vascular events following injections of vascular endothelium growth factor (VEGF) antagonists.MethodsCollaborative multicenter case series (48 cases), literature reviews (32 cases), and reports to the FDA (64 cases) of patients that had vascular occlusions during anti-VEGF therapy were collected and analyzed.ResultsA total of 144 cases of ocular vascular events were identified, with these diagnosed a median of 15 days after anti-VEGF injection. The majority of patients had pre-existing risk factors for cardiovascular events and nine patients had a prior history of glaucoma. Mean visual acuity dropped by 6.4 lines with severe visual loss after injection to NLP (five eyes), LP (six eyes), and HM (two eyes). The overall risk of ocular vascular events following a VEGF antagonist injection was 0.108% in the general population and 2.61% in the diabetic population. Mean retinal arterial constriction after intravitreal bevacizumab in 13 eyes was 21% (standard deviation = 27%), and mean retinal venous constriction was 8% (standard deviation = 30%).ConclusionOcular vascular events are rare during anti-VEGF therapy, but can lead to severe visual loss and may be caused by a number of factors including the vasoconstrictor effect of the drug, a post-injection rise of intraocular pressure, patient stress as a result of the procedure, and the patient’s natural history of underlying ocular or systemic diseases. The diabetic population appears to have a tendency towards ocular vascular occlusions.

show abstract

A Prospective Study of Blood Pressure and Intraocular Pressure Changes in Hypertensive and Nonhypertensive Patients After Intravitreal Bevacizumab Injection

Abstract: Intravitreal bevacizumab injection is safe in terms of blood pressure and IOP in both hypertensive and nonhypertensive patients after 6 months of follow-up.

Cited by 30 publications

References 25 publications

Blood pressure changes after intravitreal bevacizumab in patients grouped by ocular pathology

Blood pressure changes after intravitreal bevacizumab in patients grouped by ocular pathology

Serum Concentration of Bevacizumab after Intravitreal Injection in Experimental Branch Retinal Vein Occlusion

Insight into 144 patients with ocular vascular events during VEGF antagonist injections

Contact Info

Product

Resources

About