Effect of Intravitreal Injections on Retinal Imaging Metrics in Glaucomatous and Non-Glaucomatous Eyes

Nuesi, Ronaldo; Swaminathan, Swarup S.

doi:10.1007/s40135-020-00235-z

Cited by 5 publications

(2 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is biological plausibility that the repetitive and transient IOP elevations after intravitreal injections might further aggravate the glaucomatous optic neuropathy, given the already damaged ganglion cell axons and the dysfunctional mechanisms of IOP regulation that these eyes present. 4,[7][8][9][10][11] The initial studies that investigated this matter presented conflicting results.…”

Section: Discussionmentioning

confidence: 99%

Effect of Repeated Intravitreal Injections in Glaucoma Spectrum Diseases

Vilares-Morgado,

Correia,

Ferreira

et al. 2023

OPTH

View full text Add to dashboard Cite

To evaluate whether repeated intravitreal injections (IVI) with an anti-vascular endothelial growth factor (anti-VEGF) agent are associated with glaucomatous progression in eyes with glaucoma spectrum diseases (GSD). Methods: Single-center, retrospective, longitudinal study of patients with bilateral and similar GSD who: (1) received ≥8 IVI in only one eye during the study period; (2) had ≥2 retinal nerve fiber layer thickness (RNFL) measurements obtained by spectral-domain optical coherence tomography (SD-OCT) at least 12 months apart. The primary outcome was the absolute RNFL thickness change, comparing injected and fellow uninjected eyes. Linear mixed effects models were constructed, including a multivariable model. Results: Sixty-eight eyes from 34 patients were included, 34 injected and 34 fellow uninjected eyes. Average baseline age was 67.68 ±21.77 years with a follow-up of 3.66±1.89 years and 25.12±14.49 IVI. RNFL thickness decreased significantly from 80.92±15.78 to 77.20±17.35 μm (p<0.001; −1.18±1.93 μm/year) in injected eyes and from 79.95±17.91 to 76.61±17.97 μm (p<0.001; −1.07±0.98 μm/ year) in uninjected eyes. In a multivariable linear mixed model of injected eyes, only higher baseline RNFL thickness (p < 0.001) significantly predicted higher absolute RNFL thickness loss. Neither absolute RNFL thickness variation (p=0.716) nor RNFL rate (p=0.779) was significantly different between paired injected and uninjected eyes. Absolute IOP variation was not significantly different between groups (16.62±4.77 to 15.09±4.34 mmHg in injected eyes and 17.68±5.01 to 14.50±3.39 mmHg in fellow uninjected eyes; p=0.248). The proportion of eyes receiving glaucoma medical treatment increased significantly in both groups (55.9% to 76.5% in injected eyes; p=0.039; 58.8% to 76.5% in uninjected eyes; p = 0.031). The number of glaucoma medications also increased significantly in both groups (1.03±1.11 to 1.59±1.18 glaucoma medications in injected eyes; p=0.003; 1.09±1.11 to 1.56±1.19 glaucoma medications in uninjected eyes; p=0.003). Conclusion: Repeated IVI do not seem to accelerate glaucomatous progression. Future studies with a longer follow-up are needed.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of Repeated Intravitreal Injections in Glaucoma Spectrum Diseases

Vilares-Morgado,

Correia,

Ferreira

et al. 2023

OPTH

View full text Add to dashboard Cite

show abstract

“…Our result also showed the risks of glaucoma was not statistically different between the IVA and IVR groups, but we excluded the patients with glaucoma history from these groups. Patients with preexisting glaucoma may be more susceptible to further retinal nerve fiber injury after repeated post-injection IOP spikes [ 48 ]. Additional studies are required to establish the link between the long-term risk of glaucomatous optic neuropathy and the use of anti-VEGF agents in patients with preexisting glaucoma.…”

Section: Discussionmentioning

confidence: 99%

Comparison of risks of arterial thromboembolic events and glaucoma with ranibizumab and aflibercept intravitreous injection: A nationwide population‐based cohort study

et al. 2022

View full text Add to dashboard Cite

Background To compare intravitreal aflibercept injection with intravitreal ranibizumab injection for the risk of major arterial thromboembolic events (ATEs) and glaucoma. Methods This retrospective, nationwide cohort study investigated 15 611 and 3867 patients aged >50 years with at least one pharmacy claim for intravitreal ranibizumab injection and aflibercept injection between 2011 and 2016, respectively. The inverse probability of treatment weighting method was performed to adjust the baseline difference between the two groups and the hazard risk of adverse events was estimated using the Cox proportional regression model. Results No significant difference was noted between intravitreal ranibizumab and aflibercept injection for arterial thromboembolic risk, including ischemic stroke and acute myocardial infarction, during a 2-year follow-up (adjusted hazard ratio (HR): 0.87, 95% confidence interval (CI): 0.53–1.42; P = .583). Subgroup analyses revealed that patients age >65 years (adjusted HR: 0.64, 95% CI: 0.45–0.92) and those without coronary artery disease (adjusted HR: 0.59, 95% CI: 0.37–0.95) had significantly lower arterial thromboembolic risk in the aflibercept group than in the ranibizumab group. Additionally, the risk of glaucoma development after intravitreal injection did not significantly differ between the two groups (adjusted HR: 0.63, 95% CI: 0.37–1.06; P = .084). Conclusions No significant differences in the risk of major ATEs and glaucoma were found between ranibizumab and aflibercept, and aflibercept might be safe for use in elderly patients.

show abstract