Immediate Effect of Intravitreal Bevacizumab Injection on Intraocular Pressure

Abstract

Purpose: To determine the immediate effect of intravitreal Bevacizumab on intraocular pressure (IOP) in eyes with retinal vascular disorders.
 Study Design: Interventional case series.
 Place and Duration of Study: Ophthalmology Department, Fauji Foundation Hospital, Rawalpindi, from January 2019to July 2019.
 Methods: One hundred and thirty one patients were included in this study using non probability consecutive sampling. IOP was measured before intravitreal injection (baseline) and at 5 and 30 minutes post-injection. Descriptive statistics were obtained using SPSS version 21.0.
 Results: One hundred and thirty one eyes of 131 patients were observed for IOP change after intra vitreal injection of Bevacizumab. Among them 23 (18%) were males and 108 (82.4%) were females. Mean age was 57.57 ± 13.09 years. Mean IOP at baseline was 16.16 ± 2.52 mmHg. At 5 minutes after injection, 108 eyes (82.4%) had raised IOP, maximum IOP recorded was 44 mmHg. There was a statistically significant correlation between IOP at baseline and 5 minutes with p = 0.005 (≤0.05). At 30 minutes, 94 eyes (71.7%) had IOP fallen back to normal. Statistically, an insignificant correlation was present between IOP at baseline and 30 minutes (p = 0.081) post-injection. IOP rise was not significantly correlated to gender, age, hypertension and asthma at any interval (p value > 0.05). However, IOP rise was significantly correlated in diabetic patients at 30 minutes.
 Conclusion: IOP elevation has been observed after intravitreal bevacizumab in immediate post-injection period which warrants the monitoring of IOP in this critical period to avoid serious blinding complications.
 Key Words: Bevacizumab, Vascular endothelial growth factor, Intraocular pressure, Goldmann applanation tonometer.

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

“…One of the complications is raised intraocular pressure, but its duration of elevation is important. 11,12 Our study found that the dose of intravitreal injection of Bevacizumab has a shorter-term elevation of IOP. There is a rise in IOP at 5min after the procedure, which returns to <21mmhg at 30 min to 1 hour.…”

Immediate Effect of Intravitreal Bevacizumab Injection on Intraocular Pressure

“…8,9 Zafar A et al, showed that IOP was increased during initial 5 minutes and normalized at the end of one-hour post-injection. 10 Qureshi et al, studied the effect of ocular decompression at injection site just before intravitreal injection. They divided 100 eyes into 2 groups, decompression followed by IVB and IVB without decompression.…”

Effect of Intravitreal Anti-Vascular Endothelial Growth Factor Injection on Intraocular Pressure and Systemic Blood Pressure

“…8 Another recent study on the Pakistani population by Zafar et al, evaluated the effects of intravitreal Bevacizumab injections on IOP and had similar results to our research. 12 They concluded that significant IOP elevation occurred during the immediate post-op period. 12 However, the difference with our study was that the IOP returned to near normal at 30 minutes post-injection in most of their study population, while our patients had sustained rise in IOP even after 30 min.…”

“…12 They concluded that significant IOP elevation occurred during the immediate post-op period. 12 However, the difference with our study was that the IOP returned to near normal at 30 minutes post-injection in most of their study population, while our patients had sustained rise in IOP even after 30 min. Our results were in coherence with the results of the de Vries et al, metaanalysis that showed that IOP remained significantly high on the day of injection, with multiple time interval readings and showed a downward trend from the next day onwards.…”