Short-term intraocular pressure changes after intravitreal injection of bevacizumab for retinopathy of prematurity

Purpose

To evaluate the short-term changes in intraocular pressure (IOP) after intravitreal injection of bevacizumab (IVB) in premature infants with retinopathy of prematurity (ROP).

Study design

Prospective cohort study.

Methods

Twenty-two eyes of 11 premature infants with ROP were evaluated. The control eyes were from adults who received an intravitreal injection of antivascular endothelial growth factor agent. The patients received a 0.025 mL (0.625 mg) IVB for the ROP. The IOP was measured with a rebound tonometer at baseline, immediately after the injection, and at 5, 10, 15, 20, and 30 minutes after the injection. The clinical data were collected. The main outcome measures were the IOP values at baseline, immediately after the injection, and at 5, 10, 15, 20, and 30 minutes after the injection.

Results

The mean IOP values at baseline, immediately after the injection, and at 5, 10, 15, 20, and 30 minutes after the injection were 12.3 ± 3.0, 40.1 ± 10.7, 20.8 ± 5.1, 15.1 ± 4.8, 11.9 ± 3.2, 9.9 ± 2.6, and 8.8 ± 2.1 mmHg, respectively. The IOP was significantly higher at 5 minutes after the injection (P < .01); however, the pressure in all the eyes normalized (< 21 mmHg) within 15 minutes. None of the clinical parameters, including axial length, was correlated with a high IOP after IVB.

Conclusion

In premature infants with ROP, IVB is tolerable in terms of the short-term elevation in IOP, which returned to a safe range (< 21 mmHg) within 15 minutes of the injection in all the patients. Consecutive IOP measurement might not be necessary after IVB in premature infants with ROP.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. 1.

    Stefansson E. How to prevent retinopathy of prematurity. Acta Ophthalmol. 2011;89:3–4.

    Article  PubMed  Google Scholar 

  2. 2.

    Shah PK, Prabhu V, Karandikar SS, Ranjan R, Narendran V, Kalpana N. Retinopathy of prematurity: past, present and future. World J Clin Pediatr. 2016;8:35–46.

    Article  Google Scholar 

  3. 3.

    Murakami Y, Silva RA, Jain A, Lad EM, Gandhi J, Moshfeghi DM. Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP): 24-month experience with telemedicine screening. Acta Opthalmol. 2010;88:317–22.

    Article  Google Scholar 

  4. 4.

    Quinn GE. Retinopathy of prematurity blindnesss worldwide: phenotypes in the third epidemic. Eye Brain. 2016;8:31–6.

    Article  PubMed  PubMed Central  Google Scholar 

  5. 5.

    Wang J, Xiang D. Early clinical characteristics of bacterial endophthalmitis in retinopathy of prematurity after intravitreal bevacizumab injection: a case report. Exp Ther Med. 2017;13:3563–6.

    Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Mintz-Hittner HA. The use of anti-VEGF intravitreal injections for vision threatening stage 3 retinopathy of prematurity: risk-benefit ratio. Retina. 2009;29:562–4.

    Article  PubMed  PubMed Central  Google Scholar 

  7. 7.

    Mintz-Hittner HA, Kennedy KA, Chuang AZ; BEAT-ROP Cooperative Group. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. N Engl J Med. 2011;364:603–15.

  8. 8.

    Chung EJ, Kim JH, Ahn HS, Koh HJ. Combination of laser photocoagulation and intravitreal bevacizumab (Avastin®) for aggressive zone I retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol. 2007;245:1727–30.

    Article  CAS  PubMed  Google Scholar 

  9. 9.

    Benz MS, Albini TA, Holz ER, Lakhanpal RR, Westfall AC, Iyer MN, et al. Short-term course of intraocular pressure after intravitreal injection of triamcinolone acetonide. Ophthalmology. 2006;113:1174–8.

    Article  PubMed  Google Scholar 

  10. 10.

    Frenkel RE, Mani L, Toler AR, Frenkel MP. Intraocular pressure effects of pegaptanib (Macugen) injections in patients with and without glaucoma. Am J Ophthalmol. 2007;143:1034–5.

    Article  CAS  PubMed  Google Scholar 

  11. 11.

    Bakri SJ, Pulido JS, McCannel CA, Hodge DO, Diehl N, Hillemeier J. Immediate intraocular pressure changes following intravitreal injections of triamcinolone, pegaptanib, and bevacizumab. Eye (Lond). 2009;23:181–5.

    Article  CAS  PubMed  Google Scholar 

  12. 12.

    Kim JE, Mantravadi AV, Hur EY, Covert DJ. Short-term intraocular pressure changes immediately after intravitreal injections of anti-vascular endothelial growth factor agents. Am J Ophthalmol. 2008;146:930–4.

    Article  CAS  PubMed  Google Scholar 

  13. 13.

    Hollands H, Wong J, Bruen R, Campbell RJ, Sharma S, Gale J. Short-term intraocular pressure changes after intravitreal injection of bevacizumab. Can J Ophthalmol. 2007;42:807–11.

    Article  PubMed  Google Scholar 

  14. 14.

    Singh IP, Ahmad SI, Yeh D, Challa P, Herndon LW, Allingham RR, et al. Early rapid rise in intraocular pressure after intravitreal triamcinolone acetonide injection. Am J Ophthalmol. 2004;138:286–7.

    Article  PubMed  Google Scholar 

  15. 15.

    Bakri SJ, Beer PM. The effect of intravitreal triamcinolone acetonide on intraocular pressure. Ophthalmic Surg Lasers Imaging. 2003;34:386–90.

    PubMed  Google Scholar 

  16. 16.

    Cacciamani A, Oddone F, Parravano M, Scarinci F, Di Nicola M, Lofoco G. Intravitreal injection of bevacizumab: changes in intraocular pressure related to ocular axial length. Jpn J Ophthalmol. 2013;57:63–7.

    Article  CAS  PubMed  Google Scholar 

  17. 17.

    Murray CD, Wood D, Allgar V, Walters G, Gale RP. Short-term intraocular pressure trends following intravitreal ranibizumab injections for neovascular age-related macular degeneration: the role of oral acetazolamide in protecting glaucoma patients. Eye (Lond). 2014;28:1218–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Song S, Yu XB, Dai H. Effect of prophylactic intraocular pressure-lowering medication (brinzolamide) on intraocular pressure after ranibizumab intravitreal injection: a case-control study. Indian J Ophthalmol. 2016;64:762–6.

    Article  PubMed  PubMed Central  Google Scholar 

  19. 19.

    An international classification of retinopathy of prematurity. The committee for the classification of retinopathy of prematurity. Arch Ophthalmol. 1984;102:1130–4.

    Article  Google Scholar 

  20. 20.

    ICROP Committee for Classification of Late Stages ROP. An international classification of retinopathy of prematurity, II: the classification of retinal detachment. Arch Ophthalmol. 1987;105:906–12.

    Article  Google Scholar 

  21. 21.

    Cryotherapy for retinopathy of prematurity cooperative group. Multicenter trial of cryotherapy for retinopathy of prematurity. Arch Ophthalmol. 1988;106:471–9.

    Article  Google Scholar 

  22. 22.

    Kim KN, Jeoung JW, Park KH, Yang MK, Kim DM. Comparison of the new rebound tonometer with Goldman applanation tonometer in a clinical setting. Acta Ophthalmol. 2013;91:e392–6.

    Article  PubMed  Google Scholar 

  23. 23.

    Chhablani J, Rani PK, Balakrishnan D, Jalali S. Unusual adverse choroidal reaction to intravitreal bevacizumab in aggressive posterior retinopathy of prematurity: the Indian Twin Cities ROP screening (ITCROPS) data base report number 7. Semin Ophthalmol. 2014;29:222–5.

    Article  PubMed  Google Scholar 

  24. 24.

    Bui BV, Batcha AH, Fletcher E, Wong VH, Fortune B. Relationship between the magnitude of intraocular pressure during an episode of acute elevation and retinal damage four weeks later in rats. PLoS One. 2013;29:e70513.

    Article  CAS  Google Scholar 

  25. 25.

    Pejovic B, Peco-Antic A, Marinkovic-Eric J. Blood pressure in non-critically ill preterm and full-term neonates. Pediatri Nephrol. 2007;22:249–57.

    Article  Google Scholar 

  26. 26.

    Hayreh SS, Zimmerman MB, Kimura A, Sanon A. Central retinal artery occlusion: retinal survival time. Exp Eye Res. 2004;78:723–36.

    Article  CAS  PubMed  Google Scholar 

  27. 27.

    Lorenz K, Zwiener I, Mirshahi A. Subconjunctival reflux and need for paracentesis after intravitreal injection of 0.1 ml bevacizumab: comparison between 27-gauge and 30-gauge needle. Graefes Arch Clin Exp Ophthalmol. 2010;248:1573–7.

  28. 28.

    Soheilian M, Karimi S, Montahae T, Nikkhah H, Mosavi SA. Effects of intravitreal injection of bevacizumab with or without anterior chamber paracentesis on intraocular pressure and peripapillary retinal nerve fiber layer thickness: a prospective study. Graefes Arch Clin Exp Ophthalmol. 2017;255:1705–12.

    Article  CAS  PubMed  Google Scholar 

  29. 29.

    O’Brien C, Clark D. Ocular biometry in pre-term infants without retinopathy of prematurity. Eye (Lond). 1994;8:662–5.

    Article  PubMed  Google Scholar 

  30. 30.

    Kent D, Pennie F, Laws D, White S, Clark D. The influence of retinopathy of prematurity on ocular growth. Eye (Lond). 2000;14:23–9.

    Article  PubMed  Google Scholar 

  31. 31.

    Harder BC, von Baltz S, Jonas BJ, Schlichtenbrede FC. Intravitreal low-dosage bevacizumab for retinopathy of prematurity. Acta Ophthalmol. 2014;92:577–81.

    Article  CAS  PubMed  Google Scholar 

  32. 32.

    Khodabande A, Niyousha MR, Roohipoor R. A lower dose of intravitreal bevacizumab effectively treats retinopathy of prematurity. J AAPOS. 2016;20:490–2.

    Article  PubMed  Google Scholar 

  33. 33.

    Connor AJ, Papastavrou VT, Hillier RJ, Shafiq A. Ultra-low-dose intravitreal bevacizumab for the treatment of prematurity. J Pediatr Ophthalmol Strabismus. 2015;52:20–1.

    Article  Google Scholar 

  34. 34.

    Shen L, You QS, Xu X, Gao F, Li B, Jonas JB. Scleral thickness in Chinese eyes. Invest Ophthalmol Vis Sci. 2015;56:2720–7.

    Article  PubMed  Google Scholar 

  35. 35.

    Chen YH, Chen SN, Lien RI, Shih CP, Chao AN, Chen KJ, et al. Refractive errors after the use of bevacizumab for the treatment of retinopathy of prematurity: 2-year outcomes. Eye (Lond). 2014;28:1080–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. 36.

    Hwang CK, Hubbard GB, Hutchinson AK, Lambert SR. Outcomes after intravitreal bevacizumab versus laser photocoagulation for retinopathy of prematurity: a 5-year retrospective analysis. Ophthalmology. 2015;122:1008–15.

    Article  PubMed  PubMed Central  Google Scholar 

  37. 37.

    Geloneck MM, Chuang AZ, Clark WL, Hunt MG, Norman AA, Packwood EA, et al. Refractive outcomes following bevacizumab monotherapy compared with conventional laser treatment. JAMA Ophthalmol. 2014;132:1327–33.

    Article  PubMed  Google Scholar 

  38. 38.

    Gunay M, Sekeroglu MA, Bardak H, Celik G, Esenulku CM, Hekimoglu E, et al. Evaluation of refractive errors and ocular biometric outcomes after intravitreal bevacizumab for retinopathy of prematurity. Strabismus. 2016;24:84–8.

    Article  PubMed  Google Scholar 

  39. 39.

    Chen SN, Lian I, Hwang YC, Chen YH, Chang YC, Lee KH, et al. Intravitreal anti-vascular endothelial growth factor treatment for retinopathy of prematurity: comparison between ranibizumab and bevacizumab. Retina. 2015;35:667–74.

    Article  CAS  PubMed  Google Scholar 

  40. 40.

    Brod RD. Surgery for diseases of the vitreous and retina. J Lancaster Gen Hosp. 2009;4:4–9.

    Google Scholar 

  41. 41.

    Basti S, Krishnamachary M, Gupta S. Results of sutures wound construction in children undergoing cataract extraction. J Pediatr Ophthalmol Strabimus. 1996;33:52–4.

    CAS  Google Scholar 

  42. 42.

    Usman Saeed M, Batra R, Qureshi F, Clark D. Reflux of drug during intra-vitreal anti-VEGF therapies. Semin Ophthalmol. 2011;26:357–60.

    Article  PubMed  Google Scholar 

  43. 43.

    Oberacher-Velten I, Prasser C, Rochon J, Ittner KP, Helbig H, Lorenz B. The effects of midazolam on intraocular pressure in children during examination under sedation. Br J Ophthalmol. 2011;95:1102–5.

    Article  PubMed  Google Scholar 

  44. 44.

    Sator-Katzenschlager SM, Oehmke MJ, Deusch E, Dolezal S, Heinze G, Wedrich A. Effects of remifentanil and fentanyl on intraocular pressure during the maintenance and recovery of anaesthesia in patients undergoing non-ophthalmic surgery. Eur J Anaesthesiol. 2004;21:95–100.

    Article  CAS  PubMed  Google Scholar 

Download references

Conflicts of interest

A. Kato, None; Y. Okamoto, None; F. Okamoto, None; M. Saito, None; Y. Miyazono, None; T. Oshika, None.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Yoshifumi Okamoto.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Corresponding Author: Yoshifumi Okamoto

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kato, A., Okamoto, Y., Okamoto, F. et al. Short-term intraocular pressure changes after intravitreal injection of bevacizumab for retinopathy of prematurity. Jpn J Ophthalmol 63, 262–268 (2019). https://doi.org/10.1007/s10384-019-00661-y

Download citation

Keywords

  • Intraocular pressure
  • Intravitreal injection of bevacizumab
  • Retinopathy of prematurity