Effects of Intravitreal Anti-VEGF Therapy on Glaucoma-like Progression in Susceptible Eyes

Gómez-Mariscal, M; Muñoz‐Negrete, Francisco J.; Fernández, Gema Rebolleda

doi:10.1097/ijg.0000000000001499

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…Increased intraocular pressure with IVI remains a concern despite a generally favourable safety profile. While IOP rise post-IVI generally tend to be transient, there is still concern that repeated episodes may be a cause or exasperating factor for glaucoma progression 2 , 3 . Pressure related ocular damage may be directly caused by pressure itself, or by indirect effects on tissue perfusion related to the elevated intraocular pressure.…”

Section: Introductionmentioning

confidence: 99%

Differential reperfusion patterns in retinal vascular plexuses following increase in intraocular pressure an OCT angiography study

Cheung

Teo

Tun

et al. 2020

Sci Rep

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To describe patterns of reperfusion in the superficial vascular plexus (SVP), deep capillary plexus (DCP) and choriocapillaris (CC) as detected on optical coherence tomography (OCTA) in cynomogulus macaque monkey model following increase in intraocular pressure by an intravitreal injection. Animal imaging study. Two cynomogulus macaque monkeys. A 100 µL intravitreal injection (IVI) of saline was given in one eye of each monkey. Serial OCTA using a Zeiss Plex Elite 9000 was used to evaluate reperfusion patterns within the SCP, DCP, and CC. OCTA evidence of perfusion. Pulsation of the central retinal artery was detected after the intraocular pressure was elevated to 98 and ≥ 99 mmHg from IVI. Episodic flow within the SVP arterioles and venules and poor visualization of flow in capillaries was noted during the initial phase of elevated pressure. As the pressure declined, the flow signal within the DCP appeared initially as dots, which progressed laterally to loops which form capillary vortex configuration. Recovery of flow within the SVP and CC appeared sooner than in the DCP. At 40 min after the injection, well after the intraocular pressure normalized, the retinal and choriocapillaris vascular perfusion showed focal defects in every layer. Compared with pre-injection images, vessel density in the DCP was 68.8% and 78.6% of baseline in monkey 1 and monkey 2, respectively. In contrast vessel density in the SVP recovered to 84.2% and 88.9% of baseline. Increases in intraocular pressure from IVI have the potential to affect every layer of blood flow in the fundus. After nominal return of intraocular pressure, focal defects in flow persisted, which may result in longer term damage to the retina.

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Section: Introductionmentioning

confidence: 99%

Differential reperfusion patterns in retinal vascular plexuses following increase in intraocular pressure an OCT angiography study

Cheung

Teo

Tun

et al. 2020

Sci Rep

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Acute and subacute macular and peripapillary angiographic changes in choroidal and retinal blood flow post-intravitreal injections

Arumuganathan

Wiest

Toro

et al. 2021

Sci Rep

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Whether post injectional acute intraocular pressure (IOP) increase is associated with decreased peripapillary and macular perfusion is still under debate. Here, we investigated early changes in the choroidal and retinal blood flow using OCTA imaging in a cohort of patients undergoing anti-VEGF intravitreal injections (IVI) for macular edema following retinal vein occlusion and diabetic retinopathy. In this prospective single-center, observational study, the pre- and post-IVI changes in retinal perfusion were examined via assessment of vessel length density (VLD) and vessel density (VD) in deep and superficial capillary segmentations (DCP and SCP), foveal avascular zone (FAZ) in SCP, as well as flow signal deficits in the choriocapillaris segmentation. Mean IOP significantly changed over the study course (p = 0.000; ANOVA). Measurements at 5 min post-IVI (33.48 ± 10.84 mmHg) differed significantly from baseline (17.26 ± 2.41 mmHg, p = 0.000), while measurements from one day, one week, and one-month post-IVI did not (p = 0.907, p = 1.000 and p = 1.000 respectively). In comparison to baseline, no changes in OCTA parameters, including FAZ, VD, VLD, and FV, were detected 5 min post-IVI. No significant alterations in OCTA parameters were observed during study course. Increased IOP spikes were detected post-IVI; however, no potential permanent ischemic retinal damage was suspected.

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Effects of Intravitreal Anti-VEGF Therapy on Glaucoma-like Progression in Susceptible Eyes

Cited by 2 publications

References 5 publications

Differential reperfusion patterns in retinal vascular plexuses following increase in intraocular pressure an OCT angiography study

Differential reperfusion patterns in retinal vascular plexuses following increase in intraocular pressure an OCT angiography study

Acute and subacute macular and peripapillary angiographic changes in choroidal and retinal blood flow post-intravitreal injections

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