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CLINICAL PREDICTORS OF SUSTAINED INTRAOCULAR PRESSURE ELEVATION DUE TO INTRAVITREAL ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY

Hoang, Quan V. MD, PhD*,†,‡,§; Tsuang, Angela J. MD, MPH§; Gelman, Rony MD, MS*,†,‡,§; Mendonca, Luis S. MD*,†; Della Torre, Kara E. MD*,†,§; Jung, Jesse J. MD§; Freund, K. Bailey MD*,†,‡,§

doi: 10.1097/IAE.0b013e318261a6f7
Original Study
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Purpose: We assess for frequency and predictive factors related to sustained intraocular pressure (IOP) elevation in eyes with neovascular age-related macular degeneration receiving intravitreal injections of ranibizumab and/or bevacizumab.

Methods: A total of 328 patients with neovascular age-related macular degeneration (449 eyes) who presented to a single physician over a 6-month period were retrospectively assessed for baseline demographic/clinical information, total number of bevacizumab and/or ranibizumab injections, and sustained IOP elevation on 2 or more consecutive visits (absolute IOP >25 mmHg, increase above baseline >10 mmHg, or IOP of >21 mmHg and increase of >5 mmHg). Cox regression survival analysis and multivariate logistic regression were performed to assess the influence of intravitreal injections on experiencing sustained IOP elevation.

Results: Overall, 32 eyes (7.1%) experienced sustained IOP elevation. Survival analysis showed a significant effect of the number of anti–vascular endothelial growth factor injections on sustained IOP elevation (hazard ratio, 1.085; 95% confidence interval: 1.06–1.11, P < 0.001). Also, there was an increased odds ratio (16.1, P = 0.008) of sustained IOP elevation in eyes receiving ≥29 injections compared with ≤12 injections. After controlling for the confounder (prior intravitreal steroid injection), total number of injections still showed a statistically significant association (P = 0.002).

Conclusion: A greater number of intravitreal anti–vascular endothelial growth factor injections is associated with an increased risk for sustained IOP elevation in eyes with neovascular age-related macular degeneration receiving intravitreal ranbizumab and/or bevacizumab.

A greater number of intravitreal ranibizumab and/or bevacizumab injections is associated with an increased risk for sustained intraocular pressure elevation in eyes with neovascular age-related macular degeneration.

*Vitreous Retina Macula Consultants of New York, New York, New York

LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Institute, New York, New York

Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York

§Department of Ophthalmology, New York University Medical Center, New York, New York.

Reprint requests: K. Bailey Freund, MD, Vitreous Retina Macula Consultants of New York, 460 Park Avenue, Fifth Floor, New York, NY 10022; e-mail: kbfnyf@aol.com

Supported by the LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Institute, and The Macula Foundation Inc, New York, NY; Genentech, Alcon, Regeneron, and Alimera (to K.B.F.).

Presented at the annual meeting of the American Society of Retina Specialists, Boston, MA, August 22, 2011.

The authors have no conflicts of interest to disclose.

© The Ophthalmic Communications Society, Inc.