[Ocular hypertension after intravitreal injections].

Area of Science:

• Ophthalmology
• Retinal Diseases
• Vascular Biology

Background:

• Age-related macular degeneration (AMD) with choroidal neovascularization is increasingly treated with intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF) agents.
• While generally safe, anti-VEGF therapy can lead to transient ocular hypertension (elevated intraocular pressure, IOP) without glaucomatous changes.
• The exact mechanisms and long-term consequences of post-IVI IOP elevation remain unclear.

Approach:

• This review synthesizes current literature on the causes and mechanisms of elevated IOP following IVI.
• It analyzes the impact of ocular hypertension on the neurosensory retina and optic nerve.
• The review examines factors contributing to the progression from transient IOP elevation to clinically significant ocular hypertension or primary open-angle glaucoma (POAG).

Key Points:

• Ocular hypertension post-IVI is a recognized side effect, typically resolving within 30-60 minutes.
• Patients with pre-existing primary open-angle glaucoma may experience prolonged IOP elevation.
• Understanding the pathogenesis is crucial for managing potential long-term visual prognosis.

Conclusions:

• Further research is needed to elucidate the precise pathogenesis of elevated IOP after IVI.
• The long-term effects of IOP fluctuations on retinal and optic nerve health require continued investigation.
• Identifying risk factors for progression to chronic ocular hypertension or POAG is essential for patient management.