Vo Kim S, Fajnkuchen F, Sarda V, Qu-Knafo L, Bodaghi B, Giocanti-Aurégan A
Ophthalmology Department, Avicenne Hospital, APHP, DHU Vision and Handicaps, Paris 13 University, 125 rue de Stalingrad, 93000, Bobigny, France.
Centre d'imagerie et de Laser, 11 rue Anoine Bourdelle, Paris, France.
Graefes Arch Clin Exp Ophthalmol. 2017 Nov;255(11):2165-2171. doi: 10.1007/s00417-017-3782-y. Epub 2017 Aug 22.
The aim of this study was to investigate the sustained intraocular pressure (IOP) elevation after repeated anti-VEGF intravitreal injections (IVI) in patients with diabetic macular edema (DME).
A retrospective study included 140 eyes without prior glaucoma, treated with at least three anti-VEGF injections for DME between 2012 and 2016. IOP elevation was defined by an increase above baseline IOP by ≥6 mmHg. Baseline IOP was defined as the mean of IOP values before treatment initiation. Three groups were differentiated: group 1 without IOP elevation, groups 2 and 3 with IOP elevation and IOP <21 mmHg (group 2) and ≥21 mmHg (group 3). Rate and several risk factors of IOP elevation were assessed and compared between the three groups.
IOP elevation occurred in ten eyes (7.1%). IOP was <21 mmHg in six eyes and ≥21 mmHg in four eyes. Statistically significant associations were found between IOP elevation and the number of injections, and HbA1c level. Two patients required local hypotonic treatment.
In a real-life setting, we confirmed in eyes with center-involved DME without prior glaucoma or IOP elevation that repeated anti-VEGF IVI may increase the risk of sustained IOP elevation in about 7% of eyes.
本研究旨在调查糖尿病性黄斑水肿（DME）患者反复玻璃体内注射抗血管内皮生长因子（anti-VEGF）后眼内压（IOP）的持续升高情况。
一项回顾性研究纳入了140只无青光眼病史的眼睛，这些眼睛在2012年至2016年间接受了至少三次用于治疗DME的抗VEGF注射。IOP升高定义为高于基线IOP≥6 mmHg。基线IOP定义为治疗开始前IOP值的平均值。分为三组：1组无IOP升高，2组和3组有IOP升高，且2组IOP<21 mmHg，3组IOP≥21 mmHg。评估并比较三组之间IOP升高的发生率及几个危险因素。
10只眼（7.1%）出现IOP升高。6只眼的IOP<21 mmHg，4只眼的IOP≥21 mmHg。发现IOP升高与注射次数及糖化血红蛋白（HbA1c）水平之间存在统计学上的显著关联。两名患者需要局部降眼压治疗。
在现实环境中，我们证实在无青光眼病史或IOP升高的累及中心凹的DME眼中，反复玻璃体内注射抗VEGF可能会使约7%的眼睛出现IOP持续升高的风险增加。
