Long-Term Effect of Anti-VEGF Agents on Intraocular Pressure in Age-Related Macular Degeneration

Abstract

Purpose: To analyze the effect of anti-vascular endothelial growth factor (VEGF) agents on intraocular pressure (IOP) in patients with neovascular age-related macular degeneration (AMD). Materials andMethods: This is a retrospective study that included 72 patients treated unilaterally with anti-VEGF agents according to a pro re nata regimen. Fellow noninjected eyes (n = 72) were used as controls. IOP variation and the development of sustained ocular hypertension (OHT) were assessed both in the injected and in the fellow eyes. Results: While the final IOP was not significantly different between the 2 groups, sustained OHT developed in 4.2% of the injected eyes and 1.4% of the controls. In the study group, no significant IOP variation was noted during follow-up in patients receiving ≤20 injections, but there was a significant increase in IOP with time in more frequently treated patients (p = 0.041). Comparison of both subgroups demonstrated that patients receiving >20 injections suffered significantly greater IOP variation (p = 0.034) during follow-up, and that these patients tended to require IOP-lowering treatment more frequently (p = 0.090). Conclusion: Multiple anti-VEGF injections lead to an increase in IOP, although this variation is not sufficient to cause development of OHT in the majority of patients.

Safety and clinical effectiveness of intravitreal administration of bevacizumab (Lumiere^®) in patients with neovascular age‑related macular degeneration

“…In this regard, and based on data collected from the study population, no noteworthy safety risks for patients receiving a minimum of 3 doses during the 6-month period (as per the protocol) were identified. These results were consistent with those of previous studies (11,(14)(15)(16)(17)(18)(19)23,(28)(29)(30)(31), further confirming that bevacizumab has a favorable safety profile for its use in nAMD. None of the serious (or severe) systemic AEs that may be associated with the parenteral administration of anti-VEGF drugs were observed (14)(15)(16)(17)(18)(19).…”

The acute and chronic effects of intravitreal anti-vascular endothelial growth factor injections on intraocular pressure: A review

“…Risk factors for chronic ocular hypertension in these studies are intuitive. The total number of injections was demonstrated to be a risk factor, 11,40,48,49,93,99 as was a greater frequency of injections 79 and a pre-existing diagnosis of glaucoma prior to initiation of IVIs. 22,40 Fruend et al observed that ranibizumab, as compared to aflibercept, had higher rates of ocular hypertension, with 8.4% of patients on monthly ranibizumab having an IOP of greater than 21mmHg on two consecutive visits compared to 3.2% and 2.7% of patients who received 2 mg and 0.5 mg of aflibercept every month, respectively.…”

Long-term effects of intravitreal bevacizumab and aflibercept on intraocular pressure in wet age-related macular degeneration

“…A report from the IRIS (Intelligent Research in Sight) Registry revealed a clinically and statistically significant sustained IOP rise overall and specifically in eyes receiving bevacizumab or ranibizumab, but not in eyes that received aflibercept [ 11 ]. The overall findings of the registry have been backed by multiple smaller studies [ 12 – 14 ].…”