Intraocular pressure after intravitreal injection of drugs_Chinese Journal of Ocular Fundus Diseases

Authors：

SongShuang , DaiHong ,  YuXiaobing

Department of Ophthalmology, Beijing Hospital, Beijing 100730, China;

Corresponding author：

YuXiaobing, Email: yuxiaobing@sina.com

Keywords：

Intravitreal injections/adverse effects; Intraocular pressure; Review

DOI：

10.3760/cma.j.issn.1005-1015.2016.04.029

Video：

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Abstract Full text Figures/Tables Video References Cited by

Corticosteroids, anti-vascular endothelial growth factor, antibiotics and antiviral were the main 4 classes of drugs for intravitreal injection. Depending on the class and volume of medication, age and gender of patients, ocular axial lengths or vitreous humour reflux, intraocular pressure (IOP) can be elevated transiently or persistently after intravitreal injection. Transient IOP elevation occurred in 2 weeks after intravitreal injection, and can be reduced to normal level for most patients. Only a small portion of such patients have very high IOP and need intervention measures such as anterior chamber puncture or lowering intraocular pressure by drugs. Long term IOP elevation is refers to persistent IOP increase after 2 weeks after intravitreal injection, and cause optic nerve irreversible damage and decline in the visual function of patients. Thus drug or surgical intervention need to be considered for those patients with high and long period of elevated IOP. Large-scale multicenter clinical trials need to be performed to evaluate the roles of the drug and patients factors for IOP of post-intravitreal injection, and to determine if it is necessary and how to use methods reducing IOP before intravitreal injection.

Citation： SongShuang, DaiHong, YuXiaobing. Intraocular pressure after intravitreal injection of drugs. Chinese Journal of Ocular Fundus Diseases, 2016, 32(4): 453-457. doi: 10.3760/cma.j.issn.1005-1015.2016.04.029 Copy

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2.	Hoang QV,Tsuang AJ,Gelman R,et al. Clinical predictors of sustained intraocular pressure elevation due to intravitreal anti-vascular endothelial growth factor therapy[J].Retina,2013,33(1):178-187. DOI:10.1097/IAE.0b013e318261a6f7.
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4.	Choi DY,Ortube MC,McCannel CA,et al.Sustained elevated intraocular pressures after intravitreal injection of bevacizumab, ranibizumab, pegaptanib[J]. Retina, 2011, 31(6):1028-1035. DOI:10.1097/IAE.0b013e318217ffde.
5.	Lanzl IM, Moster MR, Hodges DD. Intraoperative prediction of intraocular pressure for the first postoperative day following glaucoma filtration surgery[J]. Ophthalmic Surg Lasers, 1997, 28(9):780-782.
6.	Kotliar K, Maier M, Bauer S, et al. Effect of intravitreal injections and volume changes on intraocular pressure:clinical results and biomechanical model[J]. Acta Ophthalmol Scand, 2007,85(7):777-781.
7.	Pallikaris IG, Kymionis GD, Ginis HS, et al. Ocular rigidity in patients with age-related macular degeneration[J]. Am J Ophthalmol, 2006,141(4):611-615.
8.	Frenkel MP, Haji SA, Frenkel RE. Effect of prophylactic intraocular pressure-lowering medication on intraocular pressure spikes after intravitreal injections[J]. Arch Ophthalmol, 2010, 128(12):1523-1527. DOI:10.1001/archophthalmol.2010.297.
9.	Skalicky SE, Ho I, Agar A, et al. Glaucoma filtration surgery following sustained elevation of intraocular pressure secondary to intravitreal anti-VEGF injections[J]. Ophthalmic Surg Lasers Imaging,2012,43(4):328-334. DOI:10.3928/15428877-20120618-01.
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13.	Smithen LM, Ober MD, Maranan L, et al. Intravitreal triamcinolone acetonide and intraocular pressure[J]. Am J Ophthalmol, 2004,138(5):740-743.
14.	Lau LI, Chen KC, Lee FL, et al. Intraocular pressure elevation after intravitreal triamcinolone acetonide injection in a Chinese population[J]. Am J Ophthalmol, 2008,146(4):573-578. DOI:10.1016/j.ajo.2008.05.034.
15.	Rhee DJ, Peck RE, Belmont J, et al. Intraocular pressure alterations following intravitreal triamcinolone acetonide[J]. Br J Ophthalmol, 2006,90(8):999-1003.
16.	钱彤,黎晓新.玻璃体腔注射曲安奈德后的眼压改变[J].中华眼底病杂志, 2007,23(2):115-117. Qian T, Li XX. Changes of intraocular pressure after intravitreous injection with triamcinolone acetonide[J].Chin J Ocul Fundus Dis, 2007,23(2):115-117.
17.	Audren F, Tod M, Massin P, et al. Pharmacokinetic-pharmacodynamic modeling of the effect of triamcinolone acetonide on central macular thickness in patients with diabetic macular edema[J]. Invest Ophthalmol Vis Sci, 2004,45(10):3435-3441.
18.	Haller JA, Bandello F, Belfort R Jr, et al.Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion[J]. Ophthalmology, 2010, 117(6):1134-1146.DOI:10.1016/j.ophtha.2010.03.032.
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29.	Falkenstein IA, Cheng L, Freeman WR. Changes of intraocular pressure after intravitreal injection of bevacizumab (avastin)[J]. Retina, 2007,27(8):1044-1047.
30.	Kim JE, Mantravadi AV, Hur EY, et al. Short-term intraocular pressure changes immediately after intravitreal injections of anti-vascular endothelial growth factor agents[J]. Am J Ophthalmol, 2008,146(6):930-934. DOI:10.1016/j.ajo.2008.07.007.
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1. Arikan G, Saatci AO, Oner FH. Immediate intraocular pressure rise after intravitreal injection of ranibizumab and two doses of triamcinolone acetonide[J]. Int J Ophthalmol, 2011, 4(4):402-405. DOI:10.3980/j.issn.2222-3959.
2. Hoang QV,Tsuang AJ,Gelman R,et al. Clinical predictors of sustained intraocular pressure elevation due to intravitreal anti-vascular endothelial growth factor therapy[J].Retina,2013,33(1):178-187. DOI:10.1097/IAE.0b013e318261a6f7.
3. Gismondi M, Salati C, Salvetat ML, et al. Short-term effect of intravitreal injection of ranibizumab (Lucentis) on intraocular pressure[J]. J Glaucoma, 2009,18(9):658-661. DOI:10.1097/IJG.0b013e31819c4893.
4. Choi DY,Ortube MC,McCannel CA,et al.Sustained elevated intraocular pressures after intravitreal injection of bevacizumab, ranibizumab, pegaptanib[J]. Retina, 2011, 31(6):1028-1035. DOI:10.1097/IAE.0b013e318217ffde.
5. Lanzl IM, Moster MR, Hodges DD. Intraoperative prediction of intraocular pressure for the first postoperative day following glaucoma filtration surgery[J]. Ophthalmic Surg Lasers, 1997, 28(9):780-782.
6. Kotliar K, Maier M, Bauer S, et al. Effect of intravitreal injections and volume changes on intraocular pressure:clinical results and biomechanical model[J]. Acta Ophthalmol Scand, 2007,85(7):777-781.
7. Pallikaris IG, Kymionis GD, Ginis HS, et al. Ocular rigidity in patients with age-related macular degeneration[J]. Am J Ophthalmol, 2006,141(4):611-615.
8. Frenkel MP, Haji SA, Frenkel RE. Effect of prophylactic intraocular pressure-lowering medication on intraocular pressure spikes after intravitreal injections[J]. Arch Ophthalmol, 2010, 128(12):1523-1527. DOI:10.1001/archophthalmol.2010.297.
9. Skalicky SE, Ho I, Agar A, et al. Glaucoma filtration surgery following sustained elevation of intraocular pressure secondary to intravitreal anti-VEGF injections[J]. Ophthalmic Surg Lasers Imaging,2012,43(4):328-334. DOI:10.3928/15428877-20120618-01.
10. Penfold PL, Gyory JF, Hunyor AB, et al. Exudative macular degeneration and intravitreal triamcinolone:a pilot study[J]. Aust N Z J Ophthalmol, 1995,23(4):293-298.
11. 王景昭.黄斑水肿的药物和手术治疗[J].中华眼底病杂志,2004,20(5):316-319. Wang JZ. Drugs and surgery for macular edema[J].Chin J Ocul Fundus Dis, 2004,20(5):316-319.
12. Jonas JB, Degenring RF, Kreissig I, et al. Intraocular pressure elevation after intravitreal triamcinolone acetonide injection[J].Ophthalmology, 2005,112(4):593-598.
13. Smithen LM, Ober MD, Maranan L, et al. Intravitreal triamcinolone acetonide and intraocular pressure[J]. Am J Ophthalmol, 2004,138(5):740-743.
14. Lau LI, Chen KC, Lee FL, et al. Intraocular pressure elevation after intravitreal triamcinolone acetonide injection in a Chinese population[J]. Am J Ophthalmol, 2008,146(4):573-578. DOI:10.1016/j.ajo.2008.05.034.
15. Rhee DJ, Peck RE, Belmont J, et al. Intraocular pressure alterations following intravitreal triamcinolone acetonide[J]. Br J Ophthalmol, 2006,90(8):999-1003.
16. 钱彤,黎晓新.玻璃体腔注射曲安奈德后的眼压改变[J].中华眼底病杂志, 2007,23(2):115-117. Qian T, Li XX. Changes of intraocular pressure after intravitreous injection with triamcinolone acetonide[J].Chin J Ocul Fundus Dis, 2007,23(2):115-117.
17. Audren F, Tod M, Massin P, et al. Pharmacokinetic-pharmacodynamic modeling of the effect of triamcinolone acetonide on central macular thickness in patients with diabetic macular edema[J]. Invest Ophthalmol Vis Sci, 2004,45(10):3435-3441.
18. Haller JA, Bandello F, Belfort R Jr, et al.Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion[J]. Ophthalmology, 2010, 117(6):1134-1146.DOI:10.1016/j.ophtha.2010.03.032.
19. Zalewski D, Raczyńska D, Raczyńska K. Five-month observation of persistent diabetic macular edema after intravitreal injection of Ozurdex implant[J/OL]. Mediators Inflamm, 2014,2014:364143[2014-02-10]. http://dx.doi.org/10.1155/2014/364143. DOI:10.1155/2014/364143.
20. Moisseiev E, Goldstein M, Waisbourd M, et al. Long-term evaluation of patients treated with dexamethasone intravitreal implant for macular edema due to retinal vein occlusion[J]. Eye (Lond), 2013,27(1):65-71. DOI:10.1038/eye.2012.226.
21. Haller JA, Bandello F, Belfort R Jr,et al.Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion twelve-month study results[J]. Ophthalmology, 2011,118(12):2453-2460. DOI:10.1016/j.ophtha.2011.05.014.
22. Shields MB. Steroid-induced glaucoma[M]//Shields MB. Text book of Glaucoma. 3rd ed. Baltimore:Williams & Wilkins,1992:374-380.
23. Bill A. Editorial:the drainage of aqueous humor[J]. Invest Ophthalmol, 1975,14(1):1-3.
24. Singh IP, Ahmad SI, Yeh D, et al. Early rapid rise in intraocular pressure after intravitreal triamcinolone acetonide injection[J]. Am J Ophthalmol, 2004,138(2):286-287.
25. Rosenfeld PJ, Brown DM, Heier JS, et al. Ranibizumab for neovascular age-related macular degeneration[J]. N Engl J Med, 2006,355(14):1419-1431.
26. Subramanian ML, Ness S, Abedi G, et al. Bevacizumab vs ranibizumab for age-related macular degeneration:early results of a prospective double-masked, randomized clinical trial[J]. Am J Ophthalmol, 2009,148(6):875-882. DOI:10.1016/j.ajo.2009.07.009.
27. 戴虹,杨絮,喻晓兵,等.抗血管内皮生长因子单克隆抗体Ranibizumab治疗渗出型老年性黄斑变性临床观察[J].中华眼底病杂志,2008,24(3):160-163. Dai H, Yang X, Yu XB, et al. Clinical observation of intravitreal injection of Ranibizumab for exudative age-related macular degeneration[J].Chin J Ocul Fundus Dis, 2008,24(3):160-163.
28. 庄岩, 陈有信.抗血管内皮生长因子单克隆抗体Bevacizumab基础和临床研究现状[J].中华眼底病杂志,2008,24(3):227-231. Zhuang Y, Chen YX. Basic and clinical research status of bevacizumab[J].Chin J Ocul Fundus Dis,2008,24(3):227-231.
29. Falkenstein IA, Cheng L, Freeman WR. Changes of intraocular pressure after intravitreal injection of bevacizumab (avastin)[J]. Retina, 2007,27(8):1044-1047.
30. Kim JE, Mantravadi AV, Hur EY, et al. Short-term intraocular pressure changes immediately after intravitreal injections of anti-vascular endothelial growth factor agents[J]. Am J Ophthalmol, 2008,146(6):930-934. DOI:10.1016/j.ajo.2008.07.007.
31. Bakri SJ, McCannel CA, Edwards AO,et al. Persisent ocular hypertensionfollowing intravitreal ranibizumab[J]. Graefe's Arch Clin Exp Ophthalmol, 2008,246(7):955-958. DOI:10.1089/jop.2009.0076.
32. Kahook MY, Kimura AE, Wong LJ, et al. Sustained elevation in intraocular pressure associated with intravitreal bevacizumab injections[J]. Ophthalmic Surg Lasers Imaging, 2009,40(3):293-295.
33. Adelman RA, Zheng Q, Mayer HR. Persistent ocular hypertension following intravitreal bevacizumab and ranibizumab injections[J]. J Ocul Pharmacol Ther, 2010,26(1):105-110. DOI:10.1089/jop.2009.0076.
34. Tseng JJ, Vance SK, Della Torre KE, et al. Sustained increased intraocular pressure related to intravitreal antivascular endothelial growth factor therapy for neovascular age-related macular degeneration[J]. J Glaucoma, 2012,21(4):241-247. DOI:10.1097/IJG.0b013e31820d7d19.
35. Mathalone N, Arodi-Golan A, Sar S,et al. Sustained elevation of intraocular pressure after intravitreal injections of bevacizumab in eyes with neovascular age-related macular degeneration[J]. Graefe's Arch Clin Exp Ophthalmol, 2012,250(10):1435-1440. DOI:10.1007/s00417-012-1981-0.
36. 路航, 崔璟琳, 董辉, 等. 康柏西普治疗湿性年龄相关性黄斑变性的临床疗效观察[J]. 中华眼科杂志,2015,51(11):818-821.DOI:10.3760/cma.j.issn.0412-4081.2015.11.005. Lu H, Cui JL, Dong H, et al. Clinical observation of a new anti-VEGF drugs conbercept for wet age-related macular degeneration[J]. Chin J Ophthalmol, 2015,51(11):818-821. DOI:10.3760/cma.j.issn.0412-4081.2015.11.005.
37. Kahook MY, Ammar DA. In vitro effects of antivascular endothelial growth factors on cultured human trabecular meshwork cells[J]. J Glaucoma, 2010,19(7):437-441. DOI:10.1097/IJG.0b013e3181ca74de.
38. Kernt M, Welge-Lüssen U, Yu A, et al. Bevacizumab is not toxic to human anterior-and posterior-segment cultured cells[J]. Ophthalmologe, 2007,104(11):965-971.
39. Sniegowski M, Mandava N, Kahook MY. Sustained intraocular pressure elevation after intravitreal injection of bevacizumab and ranibizumab associated with trabeculitis[J]. Open Ophthalmol J, 2010,22(4):28-29. DOI:10.2174/1874364101004010028.
40. Bakri SJ, Ekdawi NS. Intravitreal silicone oil droplets after intravitreal drug injections[J]. Retina, 2008, 28(7):996-1001. DOI:10.1097/IAE.0b013e31816c6868.
41. Scott IU, Oden NL, VanVeldhuisen PC, et al. SCORE Study Report 7:incidence of intravitreal silicone oil droplets associated with staked-on vs luer cone syringe design[J]. Am J Ophthalmol, 2009,148(5):725-732. DOI:10.1016/j.ajo.2009.06.004.
42. Chung JK, Lee SJ. Streptococcus mitis/oralis endophthalmitis management without phakic intraocular lens removal in patient with iris-fixated phakic intraocular lens implantation[J/OL]. BMC Ophthalmol,2014,14:92[2014-07-15]. http://bmcophthalmol.biomedcentral.com/articles/10.1186/1471-2415-14-92. DOI:10.1186/1471-2415-14-92.
43. Banker AS, Arevalo JF, Munguia D, et al.Intraocular pressure and aqueous humor dynamics in patients with AIDS treated with intravitreal cidofovir (HPMPC) for cytomegalovirus retinitis[J]. Am J Ophthalmol, 1997, 124(2):168-180.
44. Lee EW, Hariprasad SM, Mieler WF, et al. Short-term intraocular pressure trends after intravitreal triamcinolone injection[J]. Am J Ophthalmol, 2007,143(2):365-367.
45. Frenkel RE, Mani L, Toler AR, et al. Intraocular pressure effects of pegaptanib (Macugen) injections in patients with and without glaucoma[J]. Am J Ophthalmol, 2007,143(6):1034-1035.
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Chinese Journal of Ocular Fundus Diseases

Intraocular pressure after intravitreal injection of drugs

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