Document Detail

Effect of prophylactic intraocular pressure-lowering medication on intraocular pressure spikes after intravitreal injections.
MedLine Citation:
PMID:  21149773     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine if prophylactic use of intraocular pressure (IOP)-lowering medication is effective in reducing the IOP spikes after intravitreal injections of pegaptanib, bevacizumab, and ranibizumab.
METHODS: Seventy-one patients with exudative age-related macular degeneration received intravitreal injections of 1 of 3 anti-vascular endothelial growth factor medications: 30 patients received pegaptanib (0.09 mL), 47 patients received bevacizumab (0.05 mL), and 42 patients received ranibizumab (0.05 mL). Intraocular pressure-lowering medication, 1 hour prior to the injection, was used 63%, 74%, and 66% of the time in eyes that received pegaptanib, ranibizumab, and bevacizumab, respectively. Intraocular pressure was measured prior to injection, within 1 minute after injection, and every 5 to 10 minutes until the pressure was reduced to a safe level.
RESULTS: All 3 intravitreal injections caused significant initial IOP spikes (mean [SD] IOP of 38.5 [11.56] mm Hg in the pegaptanib group, 37.75 [8.36] mm Hg in the ranibizumab group, and 34.88 [10.45] mm Hg in the bevacizumab group). The IOP reduced to less than 30 mm Hg in all 3 groups within 20 minutes. Prophylactic medication did not prevent postinjection IOP spikes. Patients with and without glaucoma showed a similar rate of IOP normalization over time in all 3 groups.
CONCLUSION: Intraocular pressure spikes after intravitreal injection of pegaptanib, ranibizumab, and bevacizumab are common and in most cases transient. Routine prophylactic use of IOP-lowering medications is essentially ineffective in preventing IOP spikes after intravitreal injection of pegaptanib, ranibizumab, and bevacizumab and therefore not necessary before the injection.
Max P C Frenkel; Shamim A Haji; Ronald E P Frenkel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of ophthalmology     Volume:  128     ISSN:  1538-3601     ISO Abbreviation:  Arch. Ophthalmol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-14     Completed Date:  2011-01-14     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  7706534     Medline TA:  Arch Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1523-7     Citation Subset:  AIM; IM    
Eye Research Foundation, Stuart, FL, USA.
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MeSH Terms
Aged, 80 and over
Angiogenesis Inhibitors / administration & dosage,  adverse effects*
Antibodies, Monoclonal / administration & dosage,  adverse effects
Antibodies, Monoclonal, Humanized
Antihypertensive Agents / therapeutic use*
Aptamers, Nucleotide / administration & dosage,  adverse effects
Intraocular Pressure / drug effects*
Intravitreal Injections
Macular Degeneration / drug therapy
Ocular Hypertension / chemically induced,  drug therapy*
Retrospective Studies
Tonometry, Ocular
Vascular Endothelial Growth Factor A / antagonists & inhibitors
Visual Acuity
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antihypertensive Agents; 0/Aptamers, Nucleotide; 0/VEGFA protein, human; 0/Vascular Endothelial Growth Factor A; 0/pegaptanib; 0/ranibizumab; 2S9ZZM9Q9V/bevacizumab
Erratum In:
Arch Ophthalmol. 2011 Mar;129(3):275

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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