Recurrent Blood Pressure Rise after Treatment with Anti-vascular Endothelial Growth Factor Agents

Wyssmüller, Iris; Schaal, Karen B.; Wolf, Sebastian; Zinkernagel, Martin S.

doi:10.1055/a-1081-1635

Cited by 2 publications

(1 citation statement)

References 13 publications

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“…Previously, Berger et al 17 have demonstrated that SBP may rise by 18 ± 15 mmHg at the time of IVI. Wyssmüller et al 18 also found that SBP rose from 157.3 ± 5.9 mmHg to 175 ± 6.7 mmHg at the time of the injection. Our study found that an SBP rise of ⩾10 and ⩾20 mmHg was seen in 83.8% and 69.5% of patients.…”

Section: Discussionmentioning

confidence: 86%

Is perioperative blood pressure monitoring during intravitreal injections important?

et al. 2022

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Background: Anti-vascular endothelial growth factor intravitreal injections (IVIs) have proved to be a boon for patients suffering from several retinal pathologies. They are one of the most commonly performed procedures in ophthalmology. A perioperative rise in blood pressure (BP) has been noted during cataract surgery. Objectives: To evaluate the perioperative BP changes during IVI, and the associated risk factors. Design: Cross-sectional observational study Methods: The patients undergoing IVI from May 2019 to August 2019 were evaluated. All the patients underwent BP measurement before, during, and 1 h after the IVI. The correlation between the demographics and, the systemic comorbidities of the patients, and the ocular condition for which IVI was given was evaluated. Results: The study included 302 patients (mean age of 59.9 ± 10.7 years). The mean increase in systolic BP (SBP) and diastolic BP (DBP) at the time of injection was 25.7 ± 21.0 and 1.3 ± 13.4 mmHg, respectively. A ⩾ 10, ⩾ 20, ⩾ 30 mmHg increase in SBP at the time of injection was seen in 83.8% ( n = 253), 69.5% ( n = 210) and 49.0% ( n = 148) patients, respectively. Forty-one (13.6%) patients developed intra-procedural hypertensive urgency, out of which six patients (14.6%) did not recover even after 1 h of the procedure. None of the patients experienced any cardiovascular events. The univariate and multivariate linear regression analyses showed that the change in intra-procedural SBP correlated positively with the age of the patient and negatively with the baseline SBP. Conclusion: There is a significant rise of SBP at the time of IVI, especially in patients with advanced age and high baseline SBP. Some of the patients can experience hypertensive urgency at the time of injection and may take more than 1 h to recover. The patients receiving IVI should undergo a detailed physician evaluation before the procedure.

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Section: Discussionmentioning

confidence: 86%

Is perioperative blood pressure monitoring during intravitreal injections important?

et al. 2022

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The ideal intravitreal injection setting: office, ambulatory surgery room or operating theatre? A narrative review and international survey

Veritti¹,

Sarao²,

Chhablani³

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Purpose This study reviews evidence and provides recommendations for the ideal setting of intravitreal injection (IVI) administration of vascular endothelial growth factor (VEGF) inhibitors. Methods A multi-step approach was employed, including content analysis of regulations and guidelines, a systematic literature review, and an international survey assessing perioperative complications and endophthalmitis incidence in relation to injection settings. The literature review searched PubMed and Cochrane databases from 2006 to 2022, focusing on studies reporting correlations between complications and treatment settings. The survey utilized a web-based questionnaire distributed to clinical sites and the international ophthalmic community, with data managed using electronic capture tools. Results We reviewed regulations and guidelines from 23 countries across five continents, finding significant variation in IVI administration settings. In most countries, IVI is primarily administered in outpatient clean rooms (96%) or offices (39%), while in others, it is restricted to ambulatory surgery rooms or hospital-based operating theatres (4%). The literature review found that endophthalmitis risk after IVI is generally low (0.01% to 0.26% per procedure), with no significant difference between office-based and operating room settings. The international survey (20 centers, 96,624 anti-VEGF injections) found low overall incidences of severe perioperative systemic adverse events and endophthalmitis, independent of injection settings. Conclusion No significant differences in perioperative complications were observed among various settings, including operating theatres, ambulatory surgery rooms, offices, hospitals, or extra-hospital environments. Choosing the appropriate clinical setting can optimize patient management, potentially increasing effectiveness, quality, productivity, and capacity.

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Recurrent Blood Pressure Rise after Treatment with Anti-vascular Endothelial Growth Factor Agents

Cited by 2 publications

References 13 publications

Is perioperative blood pressure monitoring during intravitreal injections important?

Is perioperative blood pressure monitoring during intravitreal injections important?

The ideal intravitreal injection setting: office, ambulatory surgery room or operating theatre? A narrative review and international survey

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