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Repeated intravitreal anti-VEGF injections may cause sustained elevated IOP
Br J Ophthalmol. 2011;95(8):1111-1114.
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Some patients who received intravitreal anti-VEGF injections showed sustained elevated IOP, a study found.
The retrospective study included 215 eyes that received injections of Avastin (bevacizumab, Genentech) and/or Lucentis (ranibizumab, Genentech) for wet age-related macular degeneration.
The researchers evaluated frequency of injections, number of injections and changes in IOP. Also, data were analyzed independently for patients with and without pre-existing glaucoma.
Sustained IOP elevation that required medical or laser interventions occurred in 13 eyes (6%). Sustained elevated IOP occurred in 10 eyes (9.9%) in patients treated with bevacizumab only and three eyes (3.1%) in patients treated with ranibizumab only. The difference was statistically significant (P = .049).
Statistically significantly higher rates of elevated IOP were reported in patients with pre-existing glaucoma compared with those without (33% vs. 3.1%, respectively, P < .001).
A subgroup analysis of the eyes that received bevacizumab at two different centers found that one center had an elevated IOP rate of 15.3% while the other had a rate of 2.4%. This may imply that the anti-VEGF protein itself might not be the cause of IOP elevation and raised the question of other potential variables.
“[The study] highlights a possible association between the risk of elevated IOP and the source of bevacizumab injected, another area that should be further investigated to ensure proper standards for handling, storage and preparation of protein-based therapeutic agents,” the authors said.