title: The early effects of intravitreal anti vascular endothelial growth factor agents on intraocular pressure and central corneal thickness.
abstract: To investigate the early effects of two intravitreal (IV) anti vascular endothelial growth factor agents (anti-VEGF), bevacizumab and ranibizumab, on intraocular pressure (IOP) and central corneal thickness (CCT) within the first post-injection month. This prospective study comprised 109 eyes of 109 adult cases who had IV bevacizumab or ranibizumab injections because of age-related macular degeneration (ARMD), retinal venous occlusion (RVO), diabetic retinopathy, and macular edema or central serous chorioretinopathy (CSCR). None of the cases had medical histories of any kinds of glaucoma or increased IOP and IV injection before and all of them underwent a detailed ocular examination including measurements of IOP by non-contact tonometer and CCT by ultrasonic pachymeter pre-injection. IOP measurements were repeated at 30 min and 1st, 7th, and 30th day after the injection. CCT measurements were repeated at the 7th and 30th post-injection day. Paired sample t tests were used for the statistical analysis in order to evaluate the significance of changes in IOP and CCT. The mean age of 56 male and 53 female cases was 63.58 ± 11.04 years. Fifty-six cases (51.4 %) had diabetic retinopathy, 33 cases (30.3 %) had ARMD, 11 cases (10.1 %) had RVO, and 9 cases (8.3 %) had CSCR. Bevacizumab was used in 97 (89 %) cases and ranibizumab was used in 12 (11 %) cases. The IOP increased significantly 30 min after the injection (p < 0.001) but significant decreases were observed at the 1st, 7th, and 30th day post-injection (p < 0.001). No significant differences were observed in CCT between pre-injection and 7th and 30th post-injection day values (p = 0.924 and p = 0.589, respectively). Intravitreal bevacizumab and ranibizumab injections can cause hyper acute increase in IOP because of vitreal expansion but this effect is generally reversible in non-glaucomatous cases.
authors.affiliation: Ulucanlar Eye Research Hospital, Ulucanlar Caddesi No: 59, Altindag, 06240, Ankara, Turkey. aesrakaraagac@gmail.com.
authors.forename: Esra
authors.initials: E
authors.lastname: Omay
authors.affiliation: Ulucanlar Eye Research Hospital, Ulucanlar Caddesi No: 59, Altindag, 06240, Ankara, Turkey.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Elgin
authors.affiliation: Ulucanlar Eye Research Hospital, Ulucanlar Caddesi No: 59, Altindag, 06240, Ankara, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Sen
authors.affiliation: Ulucanlar Eye Research Hospital, Ulucanlar Caddesi No: 59, Altindag, 06240, Ankara, Turkey.
authors.forename: Pelin
authors.initials: P
authors.lastname: Yilmazbas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000068258:Bevacizumab / Q000009:adverse effects* / Q000627:therapeutic use; D003315:Cornea / Q000187:drug effects* / Q000473:pathology; D063171:Corneal Pachymetry; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000069579:Ranibizumab / Q000009:adverse effects* / Q000627:therapeutic use; D012164:Retinal Diseases / Q000188:drug therapy; D014065:Tonometry, Ocular; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab
keywords: Anti-VEGF; Bevacizumab; Central corneal thickness; Intraocular pressure; Intravitreal injection; Ranibizumab