Paris Arianna, Volpe Giulio, Perruchoud-Ader Kathrin, Casanova Alex, Menghini Moreno, Grimaldi Gabriela
Ophthalmology, Institute of Clinical Neurosciences of Southern Switzerland (INSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.
Ophthalmology, Institute of Clinical Neurosciences of Southern Switzerland (INSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
Br J Ophthalmol. 2025 Apr 22;109(5):600-605. doi: 10.1136/bjo-2024-326053.
BACKGROUND/AIMS: Intravitreal injection (IVT) of anti-vascular endothelial growth factor agents is the standard of care for several retinal diseases but can cause intraocular pressure (IOP) elevations. This study investigates short-term postinjection IOP changes following aflibercept 8 mg and faricimab, compared with aflibercept 2 mg.
This observational, prospective study included 90 patients with age-related macular degeneration or diabetic macular oedema, divided into three groups, receiving aflibercept 2 mg, aflibercept 8 mg or faricimab. IOP was measured using an iCare IC200-tonometer preinjection (T0) and at 30 s (T1), 5 min (T2) and 15 min (T3) postinjection. Primary outcomes included IOP changes at the four time points within and between treatment groups. The incidence of transient visual loss requiring paracentesis was recorded.
All groups experienced a significant IOP increase at T1, with mean IOP increase being 41.47±12.95 mm Hg for aflibercept 2 mg, 43.46±8.97 mm Hg for aflibercept 8 mg and 32.19±11.06 mm Hg for faricimab. By T2, IOP differences were not significant, and by T3, mean IOP returned within normal limits across all groups. Faricimab showed a smaller initial IOP spike than both aflibercept formulations, but this difference was not statistically significant at T2 and T3.
Transient IOP spikes are observed post-IVT of aflibercept 8 mg and faricimab, with similar trends to aflibercept 2 mg. The initial IOP elevation normalised within 15 min. Faricimab had a lower initial spike, but overall IOP profiles were comparable across different agents.
背景/目的：玻璃体内注射抗血管内皮生长因子药物是多种视网膜疾病的标准治疗方法，但可导致眼压升高。本研究比较了8毫克阿柏西普、法西单抗与2毫克阿柏西普注射后短期内眼压的变化。
这项观察性前瞻性研究纳入了90例年龄相关性黄斑变性或糖尿病性黄斑水肿患者，分为三组，分别接受2毫克阿柏西普、8毫克阿柏西普或法西单抗治疗。在注射前（T0）以及注射后30秒（T1）、5分钟（T2）和15分钟（T3）使用iCare IC200眼压计测量眼压。主要结局包括治疗组内和组间四个时间点的眼压变化。记录需要进行前房穿刺的短暂视力丧失的发生率。
所有组在T1时眼压均显著升高，2毫克阿柏西普组平均眼压升高41.47±12.95毫米汞柱，8毫克阿柏西普组为43.46±8.97毫米汞柱，法西单抗组为32.19±11.06毫米汞柱。到T2时，眼压差异不显著，到T3时，所有组的平均眼压均恢复到正常范围内。法西单抗的初始眼压峰值低于两种阿柏西普制剂，但在T2和T3时这种差异无统计学意义。
8毫克阿柏西普和法西单抗玻璃体内注射后观察到短暂的眼压峰值，与2毫克阿柏西普有相似趋势。初始眼压升高在15分钟内恢复正常。法西单抗的初始峰值较低，但不同药物的总体眼压情况相当。
