Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye · 2012
Glaucoma filtration surgery following sustained elevation of intraocular pressure secondary to intravitreal anti-VEGF injections.
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Skalicky Simon E, Ho Ivan, Agar Ashish, Bank Allan
Аннотация
BACKGROUND AND OBJECTIVE: To document cases of sustained elevation of intraocular pressure (IOP) while receiving intravitreal anti-vascular endothelial growth factor (VEGF) agents and subsequent management.
PATIENTS AND METHODS: A retrospective series of all cases managed by the authors and colleagues was performed.
RESULTS: Six patients developed sustained elevated IOP; five received ranibizumab and one bevacizumab. Four received unilateral and two received bilateral injections. Two had preexisting primary open-angle glaucoma and one had pseudoexfoliative glaucoma, all with stable IOP prior to anti-VEGF treatment. Angles were open in all cases. Peak IOP averaged 43 mm Hg (range: 34 to 60 mm Hg). The mean number of injections preceding the IOP increase was 10 (range: 1 to 20). Four patients required trabeculectomy, one selective laser trabeculoplasty, and one multiple topical medications.
CONCLUSION: A sustained increase in IOP requiring glaucoma filtering surgery is a rare but important treatment complication for patients receiving intravitreal anti-VEGF therapy, especially those with preexisting glaucoma or glaucoma risk factors.
PATIENTS AND METHODS: A retrospective series of all cases managed by the authors and colleagues was performed.
RESULTS: Six patients developed sustained elevated IOP; five received ranibizumab and one bevacizumab. Four received unilateral and two received bilateral injections. Two had preexisting primary open-angle glaucoma and one had pseudoexfoliative glaucoma, all with stable IOP prior to anti-VEGF treatment. Angles were open in all cases. Peak IOP averaged 43 mm Hg (range: 34 to 60 mm Hg). The mean number of injections preceding the IOP increase was 10 (range: 1 to 20). Four patients required trabeculectomy, one selective laser trabeculoplasty, and one multiple topical medications.
CONCLUSION: A sustained increase in IOP requiring glaucoma filtering surgery is a rare but important treatment complication for patients receiving intravitreal anti-VEGF therapy, especially those with preexisting glaucoma or glaucoma risk factors.
Предметные рубрики MeSH
AgedAged, 80 and overAngiogenesis InhibitorsAntibodies, Monoclonal, HumanizedAntihypertensive AgentsBevacizumabChoroidal NeovascularizationFemaleGlaucoma, Open-AngleHumansIntraocular PressureIntravitreal InjectionsMacular DegenerationMaleMiddle AgedOcular HypertensionRanibizumabRetrospective StudiesTrabeculectomyVascular Endothelial Growth Factor A