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Ocular Hypertension Following Intravitreal Anti-vascular Endothelial Growth Factor Agents

Drugs & Aging volume 29, pages 949–956 (2012)Cite this article

Abstract

Age-related macular degeneration (AMD) is the leading cause of severe vision loss in adults over the age of 65 years. The advent of anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections has revolutionized the management of exudative AMD. However, multiple case series of sustained elevated intraocular pressure (IOP) after intravitreal injections of anti-VEGF agents have been reported. Sustained elevated IOP has been reported with all anti-VEGF agents being used in ophthalmology and even in patients without any prior history of glaucoma. No clear correlations to injection frequency or patient characteristics have emerged from the multiple reports so far, but it appears that patients with pre-existing glaucoma or ocular hypertension and those receiving a greater number of injections with shorter injection intervals may be at a higher risk for developing ocular hypertension related to anti-VEGF agents. Until future studies elucidate the pathophysiology of sustained IOP following anti-VEGF injections, it is prudent to recognize the possibility of elevations in IOP in association with anti-VEGF therapy. Treating physicians should look for subtle optic nerve head changes and IOP measurements suspicious for glaucoma and have a low threshold for treating elevated IOP if the patient is likely to require multiple intravitreal anti-VEGF injections. Ocular hypertension following anti-VEGF injections appears to be amenable to anti-glaucoma treatment and every effort should be made to preserve the peripheral vision in these patients where central vision is already threatened by exudative AMD.

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Acknowledgments

Funding for the preparation of this article was provided in part by an unrestricted grant from Research to Prevent Blindness, Inc., New York, NY, USA. The authors have no conflicts of interest that are directly relevant to the content of this article.

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  1. Department of Ophthalmology, The Eye Institute, Medical College of Wisconsin, 925 N. 87th Street, Milwaukee, WI, 53226, USA

    Ravi S. J. Singh & Judy E. Kim

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  1. Ravi S. J. Singh
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  2. Judy E. Kim
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Correspondence to Judy E. Kim.

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Singh, R.S.J., Kim, J.E. Ocular Hypertension Following Intravitreal Anti-vascular Endothelial Growth Factor Agents. Drugs Aging 29, 949–956 (2012). https://doi.org/10.1007/s40266-012-0031-2

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  • DOI: https://doi.org/10.1007/s40266-012-0031-2

Keywords

  • Bevacizumab
  • Ranibizumab
  • Intravitreal Injection
  • Ocular Hypertension
  • Trabecular Meshwork