1. Predictors of sustained intraocular pressure elevation in eyes receiving intravitreal anti-vascular endothelial growth factor therapy.
- Author
-
Yannuzzi NA, Patel SN, Bhavsar KV, Sugiguchi F, and Freund KB
- Subjects
- Angiogenesis Inhibitors administration & dosage, Angiogenesis Inhibitors adverse effects, Antibodies, Monoclonal, Humanized adverse effects, Bevacizumab, Clinical Competence, Cross-Sectional Studies, Humans, Intravitreal Injections methods, Ocular Hypertension chemically induced, Ocular Hypertension physiopathology, Prevalence, Prognosis, Prospective Studies, Ranibizumab, Receptors, Vascular Endothelial Growth Factor adverse effects, Recombinant Fusion Proteins adverse effects, Risk Factors, Surveys and Questionnaires, United States epidemiology, Antibodies, Monoclonal, Humanized administration & dosage, Intraocular Pressure drug effects, Macular Degeneration drug therapy, Ocular Hypertension epidemiology, Receptors, Vascular Endothelial Growth Factor administration & dosage, Recombinant Fusion Proteins administration & dosage, Vascular Endothelial Growth Factor A antagonists & inhibitors
- Abstract
Purpose: To determine the intravitreal anti-vascular endothelial growth factor (VEGF) injection techniques and preferences within the retinal community and to identify potential factors associated with the development of sustained intraocular pressure (IOP) elevation in patients treated with intravitreal anti-VEGF therapy for neovascular age-related macular degeneration (AMD)., Design: Cross-sectional physician survey., Methods: Five hundred and thirty retina specialists spanning both private and academic practices were surveyed regarding current anti-VEGF intravitreal injection protocols, including the anti-VEGF drug of choice, needle gauge, injection volume, injection technique, and self-reported prevalence of sustained IOP elevation. Multivariate logistic regressions were performed to assess the potential influence of these factors on long-term IOP., Results: Two hundred ninety-two specialists (55%) reported believing that intravitreal anti-VEGF therapy may cause sustained IOP elevation. Of these responses, the most common reported prevalence was 1%-2% (48%), followed by 3%-5% (34%). There was no relationship between the frequency of sustained IOP elevation and anti-VEGF drug of choice. Physicians who injected greater than 0.05 cc in less than 1 second were 5.56 times more likely to observe a high frequency of sustained IOP elevation (P=.006, 95% CI 1.64-18.89)., Conclusions: Based on physician survey data, serial anti-VEGF injections using higher injection volumes with a rapid injection technique may potentially lead to sustained IOP elevation. The underlying mechanism for this complication may be injury to the trabecular meshwork resulting from rapid elevations in IOP. Further investigation of the relationship between injection techniques and sustained IOP elevation in the form of retrospective or prospective clinical studies is warranted., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF