Pershing Suzann, Bakri Sophie J, Moshfeghi Darius M
Ophthalmic Surg Lasers Imaging Retina. 2013 Sep-Oct;44(5):460-4. doi: 10.3928/23258160-20130909-07.
To evaluate elevated intraocular pressure (IOP) after intravitreal injections of vascular endothelial growth factor (VEGF) inhibitors and contribute toward the recognition and understanding of its mechanisms, pattern, and treatment.
Retrospective case series of VEGF-inhibitor injections at two academic centers (Stanford University and Mayo Clinic) over 4 years. Cases were evaluated for IOP elevation (≥ 24 mm Hg) or asymmetry (≥ 3 mm Hg IOP difference between eyes on three visits).
Twenty-one eyes were identified with pathologically elevated IOP after treatment. Most had delayed-onset (average: 15 months after treatment, after 10 injections) elevation. IOP-lowering therapy was required in 81%. More consecutive visits with IOP asymmetry occurred in patients developing ocular hypertension (11.1% pre-diagnosis vs 66.7% post-diagnosis; OR = 9.00, P = .003).
Elevated IOP may occur after ranibizumab or bevacizumab injections, often exhibiting a delayed and perhaps cumulative effect. The authors found significant bilateral IOP asymmetry in patients developing unilateral glaucoma after VEGF-inhibitor injections, a potential early indicator or proxy for pathologic IOP elevation.
评估玻璃体内注射血管内皮生长因子（VEGF）抑制剂后眼压升高情况，并有助于认识和理解其机制、模式及治疗方法。
对两个学术中心（斯坦福大学和梅奥诊所）4年间VEGF抑制剂注射情况进行回顾性病例系列研究。评估病例的眼压升高（≥24 mmHg）或不对称（三次就诊时双眼眼压差异≥3 mmHg）情况。
治疗后21只眼被确定为病理性眼压升高。多数为延迟性升高（平均：治疗后15个月，注射10次后）。81%的患者需要降眼压治疗。眼压不对称的连续就诊情况在发生高眼压的患者中更多见（诊断前为11.1%，诊断后为66.7%；比值比=9.00，P = 0.003）。
雷珠单抗或贝伐单抗注射后可能出现眼压升高，常表现为延迟且可能具有累积效应。作者发现VEGF抑制剂注射后发生单侧青光眼的患者存在显著的双侧眼压不对称，这可能是病理性眼压升高的潜在早期指标或替代指标。
