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Evaluation of intraocular pressure elevation after multiple injections of intravitreal ranibizumab

Authors Yu A, Seidensticker F, Schaumberger M, Welge-Lussen U, Wolf A

Received 28 November 2013

Accepted for publication 18 January 2014

Published 11 April 2014 Volume 2014:8 Pages 743—747


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 5

Alice L Yu,1,* Florian Seidensticker,1,* Markus Schaumberger,1 Ulrich Welge-Lussen,2 Armin Wolf1

1Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany; 2Department of Ophthalmology, Friedrich-Alexander-University, Erlangen, Germany

*These authors contributed equally to this work

Background: We wanted to determine whether multiple injections of intravitreal ranibizumab was associated with an elevated intraocular pressure (IOP) in patients treated for neovascular age-related macular degeneration (AMD).
Methods: This retrospective study examined 53 patients with neovascular AMD treated with multiple injections of intravitreal ranibizumab. The main outcome measure was the difference in IOP between the frequently-treated study eyes (≥15 injections) and the unfrequently-treated fellow control eyes (≤ five injections). Patients were divided into three study groups: group I (35 patients with 15 to 19 injections); group II (15 patients with 20 to 29 injections); and group III (three patients with ≥30 injections). The IOP was measured by Goldmann applanation tonometry 4 weeks after the last injection of intravitreal ranibizumab. For statistical analysis, the IOP was then correlated with the number of ranibizumab injections.
Results: Among the frequently-treated study eyes, the mean IOP was 13.68±2.91 mmHg (range, 8 to 20 mmHg). The unfrequently-treated fellow control eyes had a mean IOP of 13.45±3.09 mmHg (range, 9 to 25 mmHg). There was no significant correlation of the IOP difference between the study and control eyes with the number of ranibizumab injections (correlation coefficient 0.77; P=0.583). For each of groups I, II, and III, the difference in mean IOP between the study and control eyes was nonsignificant (P>0.05). There was also no significant association of the IOP difference between the study and control eyes with the number of ranibizumab injections for each group (P=0.391).
Conclusion: Our study did not find an increased IOP in frequently-ranibizumab-treated eyes when compared to unfrequently-treated fellow control eyes. Further studies with a greater sample size are needed to evaluate whether an increased number of ranibizumab injections is associated with IOP changes.

age-related macular degeneration, ocular hypertension, anti-VEGF therapy

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