Persisent ocular hypertension following intravitreal ranibizumab.
BACKGROUND
To describe the occurrence of ocular hypertension in four patients following injection of ranibizumab intravitreally.


METHODS
Case series.


RESULTS
Four patients had high intraocular pressure after intravitreal ranibizumab 0.5 mg. Ocular hypertension occurred 1 month after the second ranibizumab injection in patients 1 and 3, and 1 month after the first ranibizumab in patient 2. In patient 4, it occurred several hours after the first ranibizumab injection. In all patients, the IOP increase was sustained across several visits, requiring control with topical glaucoma therapy, and in two cases the addition of a systemic carbonic anhydrase inhibitor. None of the patients had a previous history of glaucoma, ocular hypertension or IOP asymmetry and the IOP was as high as 30, 34, 46, and 50 mmHg in the four patients.


CONCLUSIONS
Severe and sustained ocular hypertension may occur after intravitreal ranibizumab. Although the mechanism of the pressure rise is unknown, all eyes in our series were controlled with medical therapy.
Bakri
Sophie J
SJ
Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905, USA. sbakri@hotmail.com
McCannel
Colin A
CA
Edwards
Albert O
AO
Moshfeghi
Darius M
DM
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000959:Antihypertensive Agents / Q000627:therapeutic use; D020256:Choroidal Neovascularization / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects*; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D009798:Ocular Hypertension / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D000069579:Ranibizumab; D014065:Tonometry, Ocular; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000959:Antihypertensive Agents; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab