Kim Gyu-Nam, Han Yong-Seop, Chung In-Young, Seo Seong-Wook, Park Jong-Moon, Yoo Ji-Myong
Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea.
Semin Ophthalmol. 2013 Mar;28(2):61-7. doi: 10.3109/08820538.2012.754479.
To evaluate prospectively whether anti-glaucomatic drugs administered prior to intravitreal anti-vascular endothelial growth factor (VEGF) injection bevacizumab (Avastin,® Roche) or ranibizumab (Lucentis,® Novartis) prevents intraocular hypertension after the injection.
In total, 166 patients (175 eyes) scheduled for intravitreal anti-VEGF injection treatment were prophylactically treated 1 hour before the procedure with Dorzolamide/Timolol (Cosopt,® MSD) (Group 1, 53 eyes) or Brinzolamide/Timolol (Elazop,® Alcon) (Group 2, 84 eyes) or left untreated (Group 3, 29 eyes). Intraocular pressure was analyzed 5 minutes prior to the injection, every 5 minutes for 30 minutes after the procedure, and 1 hour, 1 day, 7 days, and 1 month after the procedure.
The intraocular pressures 5 minutes before the procedure (baseline) for Groups 1, 2, and 3 were 12.06 ± 1.85, 13.98 ± 2.68, and 13.81 ± 2.24 mmHg, respectively. Five and 30 minutes after the procedure, the intraocular pressures of the three groups were 14.12 ± 4.18, 14.87 ± 3.35, and 28.21 ± 3.16 mmHg, respectively, and 10.87 ± 1.58, 14.25 ± 2.43, and 17.48 ± 2.34 mmHg, respectively. For all three groups, the changes relative to baseline 5 and 30 minutes after injection were significant. When the three groups were divided according to whether they received bevacizumab or ranibizumab and the changes in intraocular pressure relative to baseline were analyzed, all six subgroups exhibited significant changes in intraocular pressure 5 and 30 minutes after the procedure.
The prophylactic administration of anti-glaucomatic drugs prior to intravitreal anti-VEGF injection effectively reduced the early intraocular pressure elevation. This approach was also safe and could be performed accurately.
前瞻性评估在玻璃体内注射抗血管内皮生长因子（VEGF）药物贝伐单抗（阿瓦斯汀，®罗氏）或雷珠单抗（Lucentis，®诺华）之前使用抗青光眼药物是否能预防注射后眼内压升高。
总共166例计划接受玻璃体内抗VEGF注射治疗的患者（175只眼），在手术前1小时分别接受多佐胺/噻吗洛尔（Cosopt，®默克）预防性治疗（第1组，53只眼）或布林佐胺/噻吗洛尔（Elazop，®爱尔康）预防性治疗（第2组，84只眼），或不接受治疗（第3组，29只眼）。在注射前5分钟、手术后每5分钟持续30分钟以及手术后1小时、1天、7天和1个月测量眼内压。
第1组、第2组和第3组在手术前5分钟（基线）时的眼内压分别为12.06±1.85、13.98±2.68和13.81±2.24 mmHg。手术后5分钟和30分钟时，三组的眼内压分别为14.12±4.18、14.87±3.35和28.21±3.16 mmHg，以及10.87±1.58、14.25±2.43和17.48±2.34 mmHg。对于所有三组，注射后5分钟和30分钟相对于基线的变化均具有显著性。当根据是否接受贝伐单抗或雷珠单抗将三组进行分组，并分析眼内压相对于基线的变化时，所有六个亚组在手术后5分钟和30分钟时眼内压均有显著变化。
在玻璃体内抗VEGF注射前预防性使用抗青光眼药物可有效降低早期眼内压升高。该方法安全且操作准确。
