Type of anti-VEGF agent has no effect on IOP elevations

VANCOUVER, British Columbia — Researchers found no significant differences in IOP elevations in patients treated with three different anti-VEGF agents, according to a poster presented here at the Association for Research in Vision and Ophthalmology meeting.

David Na, BS, and colleagues from the University of Maryland School of Medicine, Baltimore, evaluated 73 patients who initially received treatment with a single anti-VEGF agent.

“Between the three agents (bevacizumab, aflibercept, ranibizumab), we didn’t find any significant differences in IOP,” Na told Healio.com/OSN.

The evaluation considered race, why the patient was receiving the injection, lens status and sex, he said.

However, “the biggest limiting factor for this result was that in real life a lot of patients actually switch drugs throughout their therapy, so we are really limited by that,” he said.

“So we decided, after we showed this trend, to include patients who received a combination of all three agents, and that’s when we started to see some interesting relationships,” Na said.

Researchers evaluated patients who received only unilateral injections, “so we were able to use the untreated eye as the control eye,” he said.

“When we took into account, again, race, disease and lens status, we didn’t see any significance there, but what was interesting was that in women we saw an increase in IOP and in men we didn’t,” Na said. “I’m not sure why, but we do know that women have a smaller anterior chamber volume and perhaps that might have some influence on this finding. We’re not sure.”

Na explained that he and his colleagues chose to conduct this study “because the drugs are different sizes. A lot of the leading theories right now say these protein molecules aggregate and block this outflow of the chamber, and that might play a role in the IOP elevations.”

“Overall, we showed that the particular anti-VEGF agent doesn’t really have an impact on IOP elevations; second, consistent with what’s in the literature, the increased number of injections is associated with an increase in IOP; and, third, we saw that women had an increase in IOP and men didn’t. Lastly, the lens status, retinal disease and race didn’t seem to have an effect,” he said. – by Nancy Hemphill, ELS, FAAO

Reference:

Na D, et al. Effects of anti-vascular endothelial growth factor agents on intraocular pressure. Presented at: Association for Research in Vision and Ophthalmology; April 28-May 2, 2019; Vancouver, British Columbia.

Disclosures: The authors report no relevant financial disclosures.