title: Long-term effects of multiple intravitreal antivascular endothelial growth factor injections on intraocular pressure.
abstract: OBJECTIVE
  To evaluate long-term effects of multiple intravitreal antivascular endothelial growth factor (VEGF) injections on intraocular pressure (IOP) in eyes with neovascular age-related macular degeneration (AMD) or retinal vein occlusion (RVO).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  This study enrolled patients who underwent multiple (more than 3) intravitreal anti-VEGF injections and who were followed for more than 12 months after their last injection. IOP elevation was defined as an increase of 5 mm Hg over the baseline measurement on 2 consecutive visits. The frequency of IOP elevation was determined. A hazard ratio of each putative risk factor for IOP elevation was calculated using the Cox proportional hazard model for all participants, incorporating underlying disease as a covariate, as well as for each cohort.
  
  
  RESULTS
  Included in the analysis were 629 eyes with neovascular AMD and 95 eyes with RVO. Twenty eyes with neovascular AMD (3.0%) and 7 eyes with RVO (7.4%) experienced IOP elevation after multiple anti-VEGF injections, with an overall incidence of 3.7%. In the Cox proportional hazard analysis of total participants, a diagnosis of RVO (3.424, P = 0.005), a history of glaucoma (8.441, P = 0.001), and low baseline IOP (0.865, P = 0.040) were all significant risk factors for IOP elevation after multiple anti-VEGF injections.
  
  
  CONCLUSIONS
  A history of multiple intravitreal anti-VEGF injections was not a significant risk factor for IOP elevation in our study. IOP elevation was more common in eyes with RVO than with AMD after anti-VEGF injection.
authors.affiliation: Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Yoon Jeon
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Kyung Rim
authors.initials: KR
authors.lastname: Sung
authors.affiliation: Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Kyoung Sub
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Soo Geun
authors.initials: SG
authors.lastname: Joe
authors.affiliation: Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Joo Yong
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: June-Gone
authors.initials: JG
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea. Electronic address: yhyoon@amc.seoul.kr.
authors.forename: Young Hee
authors.initials: YH
authors.lastname: Yoon
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use; D000068258:Bevacizumab; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D058449:Intravitreal Injections; D008297:Male; D000069579:Ranibizumab; D012170:Retinal Vein Occlusion / Q000188:drug therapy*; D019233:Retreatment; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab