Repeated intravitreal injections of antivascular endothelial growth factors and risk of intraocular pressure medication use

Cui, Qi N.; Gray, Iga N; Yu, Yinxi; VanderBeek, Brian L.

doi:10.1007/s00417-019-04362-7

Cited by 19 publications

(15 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As found in the IRIS study, our analysis showed that cataract surgery was a factor that modified the IOP in treated eyes, while the number of injections was not [16]. While cataract surgery, and, thus, pseudophakic status, was associated with lowered IOP, as in other studies [21,22], this was not the case for vitrectomy. One hypothesis is that intraocular lenses, because of their smaller size than native lenses, offer less resistance to the flow of fluids from the vitreous cavity to the anterior chamber [22].…”

Section: Discussionsupporting

confidence: 67%

Mid-Term Impact of Anti-Vascular Endothelial Growth Factor Agents on Intraocular Pressure

Hannappe

Baudin

Mariet

et al. 2022

JCM

View full text Add to dashboard Cite

The effect of intraocular injections of anti-vascular endothelial growth factor (VEGF) on intraocular pressure (IOP) has not been clearly stated. We extracted data from the electronic health records at Dijon University Hospital of 750 patients who were unilaterally injected with anti-VEGF agents between March 2012 and March 2020. These were treatment-naïve patients who had received at least three injections of the same treatment (aflibercept, bevacizumab, or ranibizumab) in one eye only, and had IOP measurements before and after the injections. Fellow untreated eyes were used as comparators. A clinically significant IOP rise was determined as an IOP above 21 mmHg and an increase of at least 6 mmHg compared to baseline, or the need for IOP-lowering agents. We found an overall slight increase in IOP between treated and untreated eyes at 6 months (+0.67 ± 3.33 mmHg, 95% confidence interval 0.33–1.02, p < 0.001). Ranibizumab had a higher final IOP at 1 and 3 months. Age, sex, and the number of injections were not associated with IOP variation. Ranibizumab was associated with a higher rate of increase in clinically significant IOP at 6 months (p = 0.03). Our study confirms that anti-VEGF injections constitute a relatively safe treatment regarding their impact on IOP.

show abstract

Section: Discussionsupporting

confidence: 67%

Mid-Term Impact of Anti-Vascular Endothelial Growth Factor Agents on Intraocular Pressure

Hannappe

Baudin

Mariet

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…In a case-control study of over 800 eyes, Eadie et al 12 demonstrated higher incidence of glaucoma surgery in eyes receiving 7 or more injections per year compared with eyes receiving 3 or fewer injections per year. Cui et al 13 identified 17,113 nonglaucomatous eyes receiving intravitreal injection from the Clinformatics Data Mart Database (OptumInsight, Eden Prairie, MN). Their group demonstrated that eyes receiving more injections (14 or more injections at 2 y follow-up and 20 or more injections at 3 y follow-up) had higher odds of initiating IOP-lowering therapy or having a new diagnosis of glaucoma (defined by inclusion of a glaucoma diagnosis in medical claims data).…”

Section: Sequelae Of Postinjection Iop Elevation: Glaucoma and Retinal Nerve Fiber Layer (Rnfl) Architecturementioning

confidence: 99%

Intraocular Pressure Elevation Following Intravitreal Anti-VEGF Injections: Short- and Long-term Considerations

Levin

Chaya

Kahook³

et al. 2021

Journal of Glaucoma

View full text Add to dashboard Cite

Published studies agree that transient intraocular pressure (IOP) spikes are common after intravitreal injections of anti–vascular endothelial growth factor agents. Currently, there is no standard of care guiding if and when to prevent these IOP spikes. Furthermore, there are challenges in determining the impact of postinjection IOP elevation on the health of the retinal ganglion cells, particularly given the often-existing comorbidities of retinal and glaucoma pathology. This review highlights the current literature regarding both acute and chronic postinjection IOP elevations and discusses management of postinjection IOP elevation, especially in patients at high risk for glaucomatous damage.

show abstract

“…While the occurrence of transient IOP spikes after intravitreal injections of anti-VEGF medications is well documented in literature, their impact on the health of RGCs on RNFL thickness is (Levin et al, 2021). A large retrospective study by Cui et al (Cui et al, 2019;Levin et al, 2021) also reported an increased likelihood of initiating IOP-lowering therapy or a new glaucoma diagnosis in eyes that received more injections (14 injections in 2 years and 20 injections in 3 years), making an acute and/or chronic increase in IOP also a plausible explanation for the observed decrease in RGCL thickness.…”

Section: Iopmentioning

confidence: 99%

Impact of intravitreal ranibizumab, aflibercept and bevacizumab on retinal ganglion cell and nerve fibre layer thickness in Neovascular age‐related macular degeneration

Dail

Seitz

Sideroudi

et al. 2022

Acta Ophthalmologica

View full text Add to dashboard Cite

To compare the effects of monotherapy with intravitreal ranibizumab, aflibercept and bevacizumab on retinal ganglion cell layer (RGCL) and retinal nerve fibre layer (RNFL) in patients with naïve neovascular age-related macular degeneration (nAMD).Methods: This is a retrospective cohort study with three-groups comparison. 83 patients and 97 eyes on continuous monotherapy with an intravitreal anti-vascular endothelial growth factor (anti-VEGF) were followed for 24 months and divided into three groups according to anti-VEGF (aflibercept: 25 eyes, ranibizumab: 34 eyes, bevacizumab: 38 eyes). Main outcome measures included: RGCL and RNFL thickness, best corrected visual acuity (BCVA), central macular thickness (CMT), macular volume (MV) and the presence of intraretinal fluids (IRF), subretinal fluids (SRF) and retinal pigment epithelial atrophy (RPE-atrophy). All outcome measures were recorded at the time of the first injection, 1 and 2 years after treatment and compared longitudinally and between groups. Results:The mean age was 79 ± 7 years. The RGCL thickness, MV, CMT and the presence of IRF and SRF decreased significantly within all three medication groups (p < 0.05 for all) with no significant difference between groups over the 2-year follow-up period (p > 0.10 for all). The decrease in RNFL thickness was not significant within or between the groups after a 2-year follow-up (p > 0.055 for all). RPE-atrophy increased significantly after 2 years in all three groups (p < 0.028 for all) with no significant difference between groups at all three time points (p > 0.307 for all). BCVA was comparable between the three groups over the 2-year follow-up period (p > 0.22 for all).Conclusions: Monotherapy with intravitreal aflibercept, bevacizumab and ranibizumab was associated with comparable significant decreases in RGCL thickness, CMT, MV, IRF and SRF in naïve nAMD patients during the first 2 years of treatment. Furthermore, no significant differences either in BCVA or RNFL thickness were observed between the three intravitreal anti-VEFGs during the first 2 years of treatment.

show abstract

Repeated intravitreal injections of antivascular endothelial growth factors and risk of intraocular pressure medication use

Cited by 19 publications

References 40 publications

Mid-Term Impact of Anti-Vascular Endothelial Growth Factor Agents on Intraocular Pressure

Mid-Term Impact of Anti-Vascular Endothelial Growth Factor Agents on Intraocular Pressure

Intraocular Pressure Elevation Following Intravitreal Anti-VEGF Injections: Short- and Long-term Considerations

Impact of intravitreal ranibizumab, aflibercept and bevacizumab on retinal ganglion cell and nerve fibre layer thickness in Neovascular age‐related macular degeneration

Contact Info

Product

Resources

About