Sustained Increased Intraocular Pressure Related to Intravitreal Antivascular Endothelial Growth Factor Therapy for Neovascular Age-related Macular Degeneration

Tseng, Joseph; Vance, Sushma K; Torre, Kara E. Della; Mendonça, Luís; Cooney, Michael J.; Klancnik, James M.; Sorenson, John A.; Freund, K. Bailey

doi:10.1097/ijg.0b013e31820d7d19

Cited by 125 publications

(99 citation statements)

References 25 publications

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“…Choi et al [22] investigated 127 patients treated with bevacizumab, ranibizumab or pegaptanib and found 9.4% of the patients who devolved IOPs of >25 mm Hg. In another study, Tseng et al [23 ]present a series of 25 eyes of 23 patients who developed increased IOP due to repeated anti-VEGF therapy.…”

Section: Discussionmentioning

confidence: 99%

“…The ANCHOR [8] and PIER [10] study groups reported a transient rise in IOP which reverted back to baseline within hours of injection. Numerous other groups reported transient or even sustained elevation of IOP after intravitreal anti-VEGF therapy [15,16,17,18,19,20,21,22,23]. Our study aimed to investigate whether there is a long-term effect on IOP in AMD patients who received multiple IVTs at the different points of treatment duration.…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Intraocular Pressure Changes in Patients with Neovascular Age-Related Macular Degeneration Treated with Ranibizumab

et al. 2013

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Background/Aims: To investigate the long-term effects of multiple intravitreal injections (IVTs) of ranibizumab (Lucentis) on intraocular pressure (IOP) in patients with neovascular age-related macular degeneration. Methods: In 320 eyes, IOP measurements were performed at baseline prior to injection and compared with IOP measurements of the last visit. Correlations between mean IOP change and total number of IVTs, visual acuity or patient age were tested. Results: The mean IOP increase was 0.8 ± 3.1 mm Hg (p < 0.0001). Seven eyes showed final IOP values between 22 and 25 mm Hg. The mean follow-up was 22.7 ± 14.1 months. No further correlations between IOP change and number of IVTs, visual acuity or patient age have been found. Conclusions: This study demonstrated a statistically significant IOP increase in patients treated with repeated injections of ranibizumab. However, IOP increase required no glaucoma treatment during the study. Therefore, repeated injections with ranibizumab can be considered safe with regard to long-term IOP changes in patients without ocular hypertension or glaucoma.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-Term Intraocular Pressure Changes in Patients with Neovascular Age-Related Macular Degeneration Treated with Ranibizumab

et al. 2013

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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: 99%

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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“…The procedure is relatively safe, despite occasional reports of glaucoma, cataract and central retinal artery occlusion [18,19]. Further hazards of anti-VEGF treatment include hyphema and long term IOP elevation with serial injections [20]. The long term effectivity of Bevacizumab in controlling IOP is uncertain.…”

Section: Anti-vegf Therapymentioning

confidence: 99%

A paradigm shift in the management of neovascular glaucoma

Jeganathan¹,

Wardrop²

2016

New Front Ophthalmol

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Neovascular glaucoma (NVG) secondary to proliferative diabetic retinopathy (PDR) is a potentially devastating condition. The commonest cause of treatment failure in NVG is underlying systemic disease progression. The underlying ischemia is often refractory to medical treatment. Surgical options have evolved to include Bevacizumab in the Ophthalmologist's armamentarium. Visual prognosis can be guarded in these patients who additionally have reduced life expectancy. Thus, early diagnosis and aggressive treatment is imperative to avert visual loss, and improve their prognosis. We present a case of NVG secondary to PDR which was challenging to treat. The patient adherent to his treatment plan and achieved unusually successful results, maintaining good vision.

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Sustained Increased Intraocular Pressure Related to Intravitreal Antivascular Endothelial Growth Factor Therapy for Neovascular Age-related Macular Degeneration

Cited by 125 publications

References 25 publications

Long-Term Intraocular Pressure Changes in Patients with Neovascular Age-Related Macular Degeneration Treated with Ranibizumab

Long-Term Intraocular Pressure Changes in Patients with Neovascular Age-Related Macular Degeneration Treated with Ranibizumab

Nanosponge-Mediated Drug Delivery Lowers Intraocular Pressure

A paradigm shift in the management of neovascular glaucoma

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