J Korean Ophthalmol Soc.  2019 Apr;60(4):362-368. 10.3341/jkos.2019.60.4.362.

Analysis of Intraocular Pressure Elevation after Intravitreal Injection of Ranibizumab and Aflibercept

• Moon TK
• Ha JY
• Sung MS
• Park SW

• KMID: 2443153
• DOI: http://doi.org/10.3341/jkos.2019.60.4.362

Abstract

PURPOSE
To evaluate long-term intraocular pressure (IOP) and risk of IOP elevation after intravitreal injection of ranibizumab or aflibercept in patients with age-related macular degeneration (AMD).
METHODS
From January 2013 to December 2016, we retrospectively reviewed patients who underwent intravitreal ranibizumab or aflibercept injections for AMD. IOP was measured before injection and 1 week, 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 9 months, and 1 year after injection. Sustained IOP elevation was defined when the final IOP increased by 6 mmHg more than the pre-injection IOP, and when there were two consecutively measured values > 21 mmHg. The risk factors were then analyzed.
RESULTS
Using Kaplan-Meier survival analysis, sustained IOP elevation occurred in 9 of 80 eyes (11.3%) in 1 year, and the mean survival time was 11.50 months after injection. Five eyes (12.8%) of the ranibizumab group and four eyes (9.8%) of the aflibercept group had mean survival times of 11.39 and 11.61 months, respectively. The log-rank test showed no significant difference between the two groups (p = 0.659). A significant risk factor for sustained IOP elevation was a history of primary open-angle glaucoma (p = 0.035).
CONCLUSIONS
The incidence of sustained IOP elevation was not significantly different between the two groups. Clinicians should therefore carefully monitor the IOP before and after intravitreal ranibizumab or aflibercept injections, especially in AMD patients with primary open-angle glaucoma.

Keyword

Aflibercept; Intraocular pressure; Intravitreal injection; Ranibizumab

MeSH Terms

Glaucoma, Open-Angle
Humans
Incidence
Intraocular Pressure*
Intravitreal Injections*
Macular Degeneration
Ranibizumab*
Retrospective Studies
Risk Factors
Survival Rate
Ranibizumab

Figure

• 

  Figure 1 Cumulative probability of the sustained IOP elevation of total 80 eyes by Kaplan-Meier survival analysis. Events occurs in 9 eyes of 80 eyes, and survival rate of sustained IOP elevation was 88.8% at 12 months. Mean survival time was 11.50 months. IOP = intraocular pressure.

• 

  Figure 2 Cumulative probability of the sustained IOP elevation in ranibizumab group and aflibercept group by Kaplan-Meier survival analysis. Events occurs in 5 eyes in ranibizumab group and 4 eyes in aflibercept group. Survival rate of sustained IOP elevation was 87.2% in ranibizumab group and 90.2% in aflibercept group at 12 months. Mean survival time was 11.39 month in ranibizumab group and 11.61 month in aflibercept group. IOP = intraocular pressure.

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