Intraocular Pressure Changes and Vascular Endothelial Growth Factor Inhibitor Use in Various Retinal Diseases:...

Area of Science:

• Ophthalmology
• Retinal Diseases
• Pharmacology

Background:

• Vascular Endothelial Growth Factor (VEGF) inhibitors are widely used for various retinal conditions.
• Long-term effects of these treatments on intraocular pressure (IOP) in routine clinical practice require thorough investigation.

Purpose of the Study:

• To evaluate long-term changes in intraocular pressure (IOP) in eyes receiving VEGF inhibitors over 12 and 24 months.
• To compare IOP changes among different VEGF inhibitors (ranibizumab, aflibercept, bevacizumab).
• To identify risk factors for clinically significant IOP increases.

Main Methods:

• Retrospective analysis of prospectively collected data from the Fight Retinal Blindness! registry.
• Inclusion of treatment-naïve eyes receiving monotherapy with ranibizumab, aflibercept, or bevacizumab.
• Measurement of IOP at routine clinical visits, with follow-up at 12 and 24 months.

Main Results:

• Overall mean IOP change was minimal (-0.5 mmHg at 12 months, -0.4 mmHg at 24 months).
• Clinically significant IOP increases (≥6 mmHg elevation to >21 mmHg) occurred in 5.6% at 12 months and 8.8% at 24 months.
• Aflibercept was associated with fewer IOP elevations compared to bevacizumab and ranibizumab (P ≤ 0.01).
• Eyes with pre-existing glaucoma showed a higher risk of IOP increases (OR 2.2 at 12 months, OR 2.1 at 24 months).

Conclusions:

• VEGF inhibitor treatment generally results in stable IOP over 12 and 24 months.
• Aflibercept demonstrated a favorable safety profile regarding IOP compared to other agents.
• Pre-existing glaucoma is a significant risk factor for IOP elevation during VEGF inhibitor therapy.