Current intravitreal therapy and ocular hypertension: A review.

Area of Science:

• Ophthalmology
• Pharmacology
• Glaucoma Research

Background:

• Intravitreal injections are widely used for various ocular conditions.
• Ocular hypertension (IOP elevation) is a known potential side effect.
• The long-term implications and association with glaucoma require further investigation.

Purpose of the Study:

• To evaluate the immediate and long-term effects of common intravitreal agents on intraocular pressure (IOP).
• To explore the association between intravitreal agent-induced IOP elevations and glaucoma development or progression.

Main Methods:

• A systematic literature review of PubMed and Cochrane databases was conducted in January 2020.
• 407 articles were initially identified, with 87 selected based on inclusion criteria and quality assessment (Levels I-III).
• Studies reporting on short-term (0-60 min) and long-term IOP changes were analyzed.

Main Results:

• All patients receiving anti-VEGF agents or triamcinolone acetonide experienced immediate IOP elevation (0-30 min post-injection), which decreased over time.
• Long-term IOP elevation data were mixed; factors like glaucoma medication pretreatment and longer axial lengths were associated with lower IOP.
• No direct data on glaucoma onset/progression were found, though some studies noted RNFL thinning with chronic anti-VEGF therapy.

Conclusions:

• Most intravitreal agents induce both short-term and long-term ocular hypertension.
• The functional consequences of these IOP changes, particularly concerning glaucoma, are not yet clearly understood.
• Further research is needed to clarify the relationship between intravitreal agent-induced IOP elevation and glaucoma development.