Frenkel Max P C, Haji Shamim A, Frenkel Ronald E P
Eye Research Foundation, Stuart, FL, USA.
Arch Ophthalmol. 2010 Dec;128(12):1523-7. doi: 10.1001/archophthalmol.2010.297.
To determine if prophylactic use of intraocular pressure (IOP)-lowering medication is effective in reducing the IOP spikes after intravitreal injections of pegaptanib, bevacizumab, and ranibizumab.
Seventy-one patients with exudative age-related macular degeneration received intravitreal injections of 1 of 3 anti-vascular endothelial growth factor medications: 30 patients received pegaptanib (0.09 mL), 47 patients received bevacizumab (0.05 mL), and 42 patients received ranibizumab (0.05 mL). Intraocular pressure-lowering medication, 1 hour prior to the injection, was used 63%, 74%, and 66% of the time in eyes that received pegaptanib, ranibizumab, and bevacizumab, respectively. Intraocular pressure was measured prior to injection, within 1 minute after injection, and every 5 to 10 minutes until the pressure was reduced to a safe level.
All 3 intravitreal injections caused significant initial IOP spikes (mean [SD] IOP of 38.5 [11.56] mm Hg in the pegaptanib group, 37.75 [8.36] mm Hg in the ranibizumab group, and 34.88 [10.45] mm Hg in the bevacizumab group). The IOP reduced to less than 30 mm Hg in all 3 groups within 20 minutes. Prophylactic medication did not prevent postinjection IOP spikes. Patients with and without glaucoma showed a similar rate of IOP normalization over time in all 3 groups.
Intraocular pressure spikes after intravitreal injection of pegaptanib, ranibizumab, and bevacizumab are common and in most cases transient. Routine prophylactic use of IOP-lowering medications is essentially ineffective in preventing IOP spikes after intravitreal injection of pegaptanib, ranibizumab, and bevacizumab and therefore not necessary before the injection.
确定预防性使用降低眼压（IOP）的药物是否能有效降低玻璃体内注射培加他尼、贝伐单抗和雷珠单抗后的眼压峰值。
71例渗出性年龄相关性黄斑变性患者接受了3种抗血管内皮生长因子药物之一的玻璃体内注射：30例患者接受培加他尼（0.09 mL），47例患者接受贝伐单抗（0.05 mL），42例患者接受雷珠单抗（0.05 mL）。在接受培加他尼、雷珠单抗和贝伐单抗注射的眼中，分别有63%、74%和66%的时间在注射前1小时使用了降低眼压的药物。在注射前、注射后1分钟内以及每隔5至10分钟测量眼压，直至眼压降至安全水平。
所有3种玻璃体内注射均导致显著的初始眼压峰值（培加他尼组平均[标准差]眼压为38.5[11.56]mmHg，雷珠单抗组为37.75[8.36]mmHg，贝伐单抗组为34.88[10.45]mmHg）。所有3组眼压在20分钟内均降至30 mmHg以下。预防性用药未能预防注射后眼压峰值。在所有3组中，有青光眼和无青光眼的患者眼压随时间恢复正常的速率相似。
玻璃体内注射培加他尼、雷珠单抗和贝伐单抗后眼压峰值常见，且在大多数情况下是短暂的。常规预防性使用降低眼压药物在预防玻璃体内注射培加他尼、雷珠单抗和贝伐单抗后的眼压峰值方面基本无效，因此在注射前没有必要使用。
