Intravitreal anti-VEGF injections reduce aqueous outflow facility in patients with neovascular age-related macular degeneration

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Title: Intravitreal anti-VEGF injections reduce aqueous outflow facility in patients with neovascular age-related macular degeneration
Authors: Wen, JC
Reina-Torres, E
Sherwood, JM
Challa, P
Liu, KC
Li, G
Chang, JYH
Cousins, SW
Schuman, SG
Mettu, PS
Stamer, WD
Overby, DR
Allingham, RR
Item Type: Journal Article
Abstract: Purpose: We assess the effect of intravitreal anti-VEGF injections on tonographic outflow facility. Methods: Patients with age-related macular degeneration who had received unilateral intravitreal anti-VEGF injections were recruited into two groups, those with ≤10 and those with ≥20 total anti-VEGF injections. Intraocular pressure and tonographic outflow facility of injected and uninjected fellow eyes were measured and compared between groups. Risk factors for development of reduced outflow facility also were assessed. Results: Outflow facility was 12% lower in the injected eyes of patients who received ≥20 anti-VEGF injections, compared to contralateral uninjected eyes (P = 0.02). In contrast, there was no facility reduction for patients with ≤10 anti-VEGF injections (P = 0.4). In patients with ocular hypertension in the uninjected eye (IOP > 21 mm Hg, n = 5), the outflow facility of injected eyes was on average 46% lower (P = 0.01) than in the uninjected fellow eyes. This was significantly greater than the difference observed in patients with IOP ≤ 21 mm Hg in the uninjected eye (P = 2 × 10−4). In patients with ocular hypertension in the injected eye (n = 6) the differences in facility and IOP between contralateral eyes were significantly greater than in patients with IOP ≤ 21 mm Hg in the injected eye (P = 2 × 10−4 and P = 7 × 10−4, respectively). Conclusions: Chronic anti-VEGF injections significantly reduce outflow facility in patients with AMD. The greatest facility reduction is observed in patients with baseline ocular hypertension. Ophthalmologists who administer anti-VEGF injections should be aware of these findings and monitor patients closely for changes in IOP or evidence of glaucoma, especially in those with pre-existing ocular hypertension.
Issue Date: 1-Mar-2017
Date of Acceptance: 27-Jan-2017
URI: http://hdl.handle.net/10044/1/49329
DOI: https://dx.doi.org/10.1167/iovs.16-20786
ISSN: 0146-0404
Publisher: Association for Research in Vision and Ophthalmology (ARVO)
Start Page: 1893
End Page: 1898
Journal / Book Title: Investigative Ophthalmology & Visual Science
Volume: 58
Issue: 3
Copyright Statement: © 2017 The Authors. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Keywords: Science & Technology
Life Sciences & Biomedicine
Ophthalmology
anti-VEGF
aqueous outflow facility
ocular hypertension
intraocular pressure
INTRAOCULAR-PRESSURE ELEVATION
GROWTH-FACTOR THERAPY
SUSTAINED ELEVATION
CATARACT-EXTRACTION
BEVACIZUMAB
RANIBIZUMAB
EYES
PREDICTORS
PEGAPTANIB
GLAUCOMA
Aged
Aged, 80 and over
Angiogenesis Inhibitors
Aqueous Humor
Bevacizumab
Choroidal Neovascularization
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Humans
Intraocular Pressure
Intravitreal Injections
Male
Middle Aged
Ranibizumab
Time Factors
Tonometry, Ocular
Treatment Outcome
Wet Macular Degeneration
Aqueous Humor
Humans
Choroidal Neovascularization
Angiogenesis Inhibitors
Tonometry, Ocular
Treatment Outcome
Follow-Up Studies
Intraocular Pressure
Dose-Response Relationship, Drug
Time Factors
Aged
Aged, 80 and over
Middle Aged
Female
Male
Wet Macular Degeneration
Intravitreal Injections
Bevacizumab
Ranibizumab
Science & Technology
Life Sciences & Biomedicine
Ophthalmology
anti-VEGF
aqueous outflow facility
ocular hypertension
intraocular pressure
INTRAOCULAR-PRESSURE ELEVATION
GROWTH-FACTOR THERAPY
SUSTAINED ELEVATION
CATARACT-EXTRACTION
BEVACIZUMAB
RANIBIZUMAB
EYES
PREDICTORS
PEGAPTANIB
GLAUCOMA
11 Medical And Health Sciences
06 Biological Sciences
Ophthalmology & Optometry
Publication Status: Published
Open Access location: http://iovs.arvojournals.org/article.aspx?articleid=2616206
Appears in Collections:Faculty of Engineering
Bioengineering



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