University of Illinois Eye & Ear Infirmary, Chicago, Illinois 60612, USA.
Curr Opin Ophthalmol. 2012 Mar;23(2):105-10. doi: 10.1097/ICU.0b013e32834ff41d.
To summarize the findings of recent reports of short-term and sustained intraocular pressure (IOP) rise associated with intravitreal antivascular endothelial growth factor (VEGF) injections and to guide the management of this infrequent complication.
Short-term increases in IOP are common immediately after intravitreal anti-VEGF injection. IOP takes longer to reach a safe level in patients with a history of glaucoma or ocular hypertension. Preinjection medicinal therapy and ocular decompression therapy may blunt this short-term IOP rise. Sustained increases in IOP are relatively infrequent, but are likely to necessitate intervention for IOP-lowering. A 'pro re nata' (PRN) injection protocol may obviate the need for intervention. The pathophysiology of sustained IOP rise is poorly understood, but may relate to repackaging processes undertaken by the pharmacies that compound these agents.
Treating physicians should be aware of the potential for short-term and sustained IOP rise associated with intravitreal anti-VEGF injection therapy. Considerations for management include prophylactic IOP-lowering with medicinal therapy and/or preinjection ocular decompression for patients with a history of glaucoma or ocular hypertension and switching to a 'PRN' injection protocol in patients suffering a sustained rise in IOP.
总结近期有关玻璃体内抗血管内皮生长因子（VEGF）注射后短期和持续眼压（IOP）升高的报告结果，并为这种罕见并发症的管理提供指导。
玻璃体内抗 VEGF 注射后，IOP 短期内升高很常见。有青光眼或高眼压病史的患者，IOP 需要更长时间才能达到安全水平。预注射药物治疗和眼球减压治疗可能会减轻这种短期的 IOP 升高。持续的 IOP 升高相对少见，但可能需要进行降压干预。“按需”（PRN）注射方案可能避免需要干预。持续 IOP 升高的病理生理学机制尚不清楚，但可能与药剂师进行的再包装过程有关。
治疗医生应意识到玻璃体内抗 VEGF 注射治疗可能导致短期和持续的 IOP 升高。管理的考虑因素包括预防性降低 IOP 的药物治疗和/或眼球减压治疗，对于有青光眼或高眼压病史的患者，以及对于持续 IOP 升高的患者，改用“PRN”注射方案。
