Persistent Ocular Hypertension Following Intravitreal Bevacizumab and Ranibizumab Injections

Adelman, Ron A.; Qi, Zhongang; Mayer, Hylton R.

doi:10.1089/jop.2009.0076

Cited by 149 publications

(137 citation statements)

References 18 publications

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“…No instances of endophthalmitis were reported in this study. In addition, the instances of vitreous hemorrhage, hypersensitivity reaction, traumatic cataract, retinal tear, and retinal detachment were infrequent per injection (0 to 0.1% of injections) and per patient (0 to 0.8% of patients).In this study, increased IOP was the most frequently reported POAE (6.6% per patient), which is consistent with the reported incidence of increased IOP in a mixed disease population (ranges from 3.4% to 11% per patient) [15,16]. Abbreviations: AMD = age-related macular degeneration, N = number of patients in each treatment group, n = number of patients with a response, POAE = pertinent ocular adverse event, IOP = intraocular pressure, CI = confidence interval, SD = standard deviation *Incidence rate per patient: the number of patients with specific POAEs divided by the total number of patients that received injections in treated eye(s)…”

Section: Discussionsupporting

confidence: 89%

Ocular Safety of Intravitreal Injections of Age-Related Macular Degeneration Treatments in a Prospective Observational Cohort Study in Europe

Huang¹,

Sultan²,

Zhou³

et al. 2015

J Clin Res Ophthalmol

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036 AbstractPurpose:Estimate the incidence of pertinent ocular adverse events (POAEs) related to intravitreal (IVT)injections for age-related macular degeneration (AMD) treatments in Europe. Results: 501 patients from 69 sites in 13 countries were enrolled.The mean age was 73.6 years. Most patients received monotherapy (80.4%), were white (97.4%), and never smoked (65.3%).The total number of IVT injections for AMD treatment was 3,754 among those patients. The incidence of POAEs was low overall (0 to 1.28% per injection, 0 to 6.6% per patient).Increased IOP was the most frequently reported POAE. There was a positive association between the incidence of increased IOP and the number of injections received.Endophthalmitis was not reported. Methods Conclusions:The incidence of POAEs related to IVT injections in this study was low and similar to that reported in the literature.

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Section: Discussionsupporting

confidence: 89%

Ocular Safety of Intravitreal Injections of Age-Related Macular Degeneration Treatments in a Prospective Observational Cohort Study in Europe

Huang¹,

Sultan²,

Zhou³

et al. 2015

J Clin Res Ophthalmol

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“…74,75 While some patients respond to intravitreal injection with sustained elevation of IOP, most do not even after multiple injections. [76][77][78][79][80][81][82] In our study, we performed intravitreal injection of drug-loaded NS once and observed IOPlowering effects out to 32 days (Fig. 4).…”

Section: Discussionmentioning

confidence: 62%

Nanosponge-Mediated Drug Delivery Lowers Intraocular Pressure

Lambert

Carlson

Ende

et al. 2015

Trans. Vis. Sci. Tech.

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Purpose: We examined the efficacy of an extended-release drug delivery system, nanosponge (NS) encapsulated compounds, administered intravitreally to lower intraocular pressure (IOP) in mice.Methods: Bilateral ocular hypertension was induced in mice by injecting microbeads into the anterior chamber. Hypertensive mice received NS loaded with ocular hypotensive drugs via intravitreal injection and IOP was monitored. Retinal deposition and retinal ganglion cell (RGC) uptake of Neuro-DiO were examined following intravitreal injection of Neuro-DiO-NS using confocal microscopy.Results: Brimonidine-loaded NS lowered IOP 12% to 30% for up to 6 days (P , 0.02), whereas travoprost-NS lowered IOP 19% to 29% for up to 4 days (P , 0.02) compared to saline injection. Three bimatoprost NS were tested: a 400-nm NS and two 700-nm NS with amorphous (A-NS) or amorphous/crystalline (AC-NS) crosslinkers. A single injection of 400 nm NS lowered IOP 24% to 33% for up to 17 days compared to saline, while A-NS and AC-NS lowered IOP 22% to 32% and 18% to 26%, respectively, for up to 32 days (P , 0.046). Over time retinal deposition of Neuro-DiO increased from 19% to 71%; Neuro-DiO released from NS was internalized by RGCs.Conclusions: A single injection of NS can effectively deliver ocular hypotensive drugs in a linear and continuous manner for up to 32 days. Also, NS may be effective at targeting RGCs, the neurons that degenerate in glaucoma.Translational Relevance: Patient compliance is a major issue in glaucoma. The use of NS to deliver a controlled, sustained release of therapeutics could drastically reduce the number of patients that progress to vision loss in this disease.

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“…Although intravitreal injections and sustained release devices deliver adequate drug levels to the retina, repeated intraocular injections as well as surgical placement of intravitreal implants are associated with complications such as cataracts, elevated intraocular pressure, hemorrhage, retinal detachment, and endophthalmitis (Adelman et al, 2010;Sampat and Garg, 2010;Sato et al, 2010). To overcome the risks associated with intravitreal route and to improve on inefficient drug delivery to the back of the eye after topical and oral administration, periocular/transscleral routes such as subconjunctival and subtenon routes may offer more promising alternatives for retinal drug delivery (Cruysberg et al, 2002;Ayalasomayajula and Kompella, 2004;Raghava et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Influence of Drug Solubility and Lipophilicity on Transscleral Retinal Delivery of Six Corticosteroids

Thakur

Kadam²,

Kompella³

2011

Drug Metab Dispos

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ABSTRACT:The influence of drug properties including solubility, lipophilicity, tissue partition coefficients, and in vitro transscleral permeability on ex vivo and in vivo transscleral delivery from corticosteroid suspensions was determined. Solubility, tissue/buffer partition coefficients for bovine sclera and choroid-retinal pigment epithelium (CRPE), and in vitro bovine sclera and sclera-choroid-retinal pigment epithelium (SCRPE) transscleral transport were determined at pH 7.4 for triamcinolone, prednisolone, dexamethasone, fluocinolone acetonide, triamcinolone acetonide, and budesonide in solution. Ex vivo and in vivo transscleral delivery was assessed in Brown Norway rats after posterior subconjunctival injection of a 1 mg/ml suspension of each corticosteroid. Corticosteroid solubility and partition coefficients ranged from ϳ17 to 300 g/ml and 3.0 to 11.4 for sclera and from 7.1 to 35.8 for CRPE, respectively, with the more lipophilic molecules partitioning more into both tissues.

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Persistent Ocular Hypertension Following Intravitreal Bevacizumab and Ranibizumab Injections

Abstract: Persistent OHT may occur after intravitreal anti-VEGF injection in patients with no previous diagnosis of glaucoma or OHT. OHT may persist across several visits and patients may require IOP-lowering therapy. Sustained elevation in IOP usually occurs after multiple injections.

Cited by 149 publications

References 18 publications

Ocular Safety of Intravitreal Injections of Age-Related Macular Degeneration Treatments in a Prospective Observational Cohort Study in Europe

Ocular Safety of Intravitreal Injections of Age-Related Macular Degeneration Treatments in a Prospective Observational Cohort Study in Europe

Nanosponge-Mediated Drug Delivery Lowers Intraocular Pressure

Influence of Drug Solubility and Lipophilicity on Transscleral Retinal Delivery of Six Corticosteroids

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