Author: Renato Correia Barbosa
Co-authors: Ricardo Bastos, Rita Basto, Ana Rita Viana, Alexandre Silva, Paula Tenedorio
Abstract
Purpose: Intravitreal treatments, namely anti-VEGF agents, are the most validated treatment option for various retinal and choroidal disorders. The volume expansion caused by their delivery is associated with rises in intraocular pressure.The objective of this study was to measure and interpret short-term pressure variation after intravitreal injections of the anti-vascular endothelial growth factor drug aflibercept (Eylea©) and to identify variables and risk factors for increased pressure spikes.
Setting/Venue: All patients were treated in the operating room of Hospital Pedro Hispano, in Matosinhos, Portugal.
Methods: A cohort, prospective observational study, was conducted in 103 eyes treated with intravitreal aflibercept (Eylea©). IOP was measured using the Icare® TA01i tonometer immediately before, and 1, 5, and 20 minutes after the procedure. Patient data were reviewed according to age, gender, diagnostic, phakic status, and glaucoma history.
Results: Mean values of IOP before, and 1, 5 and 20 minutes after the injection were 14,89 (±4,19) mmHg, 36,77 (±11,46) mmHg, 24,17 (±7,81) mmHg and 16,54 (±5,26) mmHg, respectively. More than three-quarters (76,7%) of the patients had an IOP higher than 30 mmHg 1 minute after the injection. Almost half (47,57%) had an IOP higher than 40 mmHg. Significant differences were found in patients with a history of glaucoma, 20 minutes after the injection. No significant differences were found between phakic and pseudophakic patients.
Conclusion: Phakic status didn’t seem to affect IOP after intravitreal injections. Patients with a history of glaucoma may have a slower postinjection IOP decrease. These patients are at a greater risk for progressive worsening of their glaucoma due to repeated IOP spikes after multiple IVI. IOP should be closely monitored, and a low threshold for optimizing topical therapy should be established.
