Department of Ophthalmology, Turku University Hospital, PO Box 52, 20521, Turku, Finland.
Department of Ophthalmology, University of Turku, Turku, Finland.
BMC Ophthalmol. 2021 Aug 28;21(1):312. doi: 10.1186/s12886-021-02076-1.
To evaluate the incidence of sustained elevation of intraocular pressure (SE-IOP) associated with intravitreal injections of anti-vascular endothelial growth factors (anti-VEGF) bevacizumab and aflibercept in patients with wet age-related macular degeneration (wAMD).
A retrospective cohort study consisting of 120 eyes from 120 patients with anti-VEGF treatment for wAMD. Three different anti-VEGF groups were considered: i) 71 cases receiving bevacizumab only, ii) 49 cases receiving bevacizumab before switch to aflibercept, iii) 49 cases after switch to aflibercept. 120 uninjected fellow eyes served as controls. SE-IOP was defined as an increase from baseline ≥5 mmHg on 2 consecutive follow-up visits. The incidence of SE-IOP was analysed using exact Poisson tests and survival analysis. The time course of IOP was evaluated with linear mixed effect modelling.
In total, 6 treated eyes (2.38% incidence per eye-year) and 9 fellow eyes (3.58% incidence per eye-year) developed SE-IOP, and survival analysis showed no statistically significant difference (p = 0.43). Furthermore, the incidence of SE-IOP did not differ between the three anti-VEGF groups. Comparing the injected eyes of patients under 70 years to those of patients over 70 years, there was a statistically significant difference in survival without SE-IOP (incidence of 16.7% vs 0.7%, respectively, p < 0.0001).
Intravitreal anti-VEGF injections were not associated with sustained elevation of IOP. These results do not support the claim that repeated anti-VEGF injections could elevate IOP.
评估抗血管内皮生长因子（anti-VEGF）bevacizumab 和 aflibercept 玻璃体内注射治疗湿性年龄相关性黄斑变性（wAMD）患者持续性眼压升高（SE-IOP）的发生率。
回顾性队列研究纳入了 120 例接受抗 VEGF 治疗的 wAMD 患者的 120 只眼。将患者分为三组：i）仅接受 bevacizumab 治疗的 71 例，ii）先转换为 aflibercept 治疗的 49 例，iii）转换为 aflibercept 治疗的 49 例。120 只未注射的对侧眼作为对照。SE-IOP 定义为两次连续随访时眼压升高≥5mmHg。采用精确泊松检验和生存分析评估 SE-IOP 的发生率。采用线性混合效应模型评估眼压的时间变化。
共有 6 只治疗眼（每眼年 2.38%的发生率）和 9 只对侧眼（每眼年 3.58%的发生率）发生 SE-IOP，生存分析显示两组间无统计学差异（p=0.43）。此外，三组间 SE-IOP 的发生率无差异。比较 70 岁以下患者和 70 岁以上患者的治疗眼，两组间无 SE-IOP 的生存差异有统计学意义（分别为 16.7%和 0.7%，p<0.0001）。
玻璃体内抗 VEGF 注射与持续性眼压升高无关。这些结果不支持重复抗 VEGF 注射会升高眼压的说法。
