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Immediate Rise in Intraocular Pressure After First-Time Intravitreal Injection of Bevacizumab
Pir S Mahar1,2, Sohail Bukhari2, Ayisha Shakeel3
1Ophthalmology, Aga Khan University Hospital, Karachi, PAK.
Cureus
|June 14, 2023
Summary
The first intravitreal injection of bevacizumab significantly increases intraocular pressure (IOP) in most patients within two hours. IOP levels returned to baseline within three hours post-injection, indicating a temporary effect.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Pharmacology
Background:
- Intravitreal anti-VEGF therapy is crucial for various chorioretinal diseases.
- Understanding immediate post-injection intraocular pressure (IOP) changes is vital for patient safety.
Purpose of the Study:
- To investigate the immediate changes in intraocular pressure (IOP) following the initial intravitreal injection of bevacizumab.
- To assess the duration and magnitude of IOP elevation post-bevacizumab administration.
Main Methods:
- An interventional case series involving 147 patients (191 eyes) undergoing their first intravitreal bevacizumab injection.
- Intraocular pressure (IOP) was monitored hourly for six hours, starting one hour before the injection.
- Exclusion criteria included prior anti-VEGF/steroid injections and a history of glaucoma.
Main Results:
- A significant majority of eyes (88.5%) experienced elevated IOP (> 21 mmHg) within five minutes post-injection.
- Mean post-injection IOP peaked at 30.44 ± 6.53 mmHg at five minutes and remained elevated for up to two hours.
- Intraocular pressure (IOP) returned to pre-injection levels by three hours post-injection.
Conclusions:
- First-time intravitreal bevacizumab injections cause a substantial, albeit temporary, increase in intraocular pressure (IOP).
- Close monitoring of IOP in the immediate post-injection period is recommended for patients receiving bevacizumab.
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