LoBue Stephen A, Albear Sinan, Martin Curtis, Guagliardo Alan, Chang Tom
Department of Ophthalmology, Acuity Eye Group, Pasadena, CA, USA.
Department of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, NY, USA.
Clin Ophthalmol. 2024 Dec 19;18:3861-3870. doi: 10.2147/OPTH.S482123. eCollection 2024.
To study the effects of anti-VEGF injections on the prevalence of ocular hypertension (OHT), sustained elevated intraocular pressure (SE-IOP), and primary open-angle glaucoma (POAG) with age-matched controls.
A retrospective case-control study was performed with neovascular age-related macular degeneration (AMD) or diabetic macular edema (DME) against a control group involving atrophic AMD or diabetic retinopathy (DR) without DME. Bevacizumab, ranibizumab, or a combination of both were used in the treatment group. OHT was defined as IOP>21 mm Hg while SE-IOP was defined as IOP that increased by > 6 mmHg or was >25 mm Hg on two or more visits, 30 days apart. Patients with a pre-existing history of glaucoma, vein occlusions, IVI steroids, and pars plana vitrectomy were excluded.
A total of 1312 eyes of 784 patients were included in the study. Using age-matched controls, the treatment and control group was further refined to 394 eyes of 224 patients compared to 340 eyes from 170 patients respectively. The mean age was 58.4 ± 8.7 for the control versus 58.8 ± 8.8 years for the treatment group. The average IOP was higher in the injection group compared to the control with 25.8 ± 9.3 versus 19.5 ± 5.1 mmHg respectively, P<0.001. Significant increases in POAG (10.7% vs 2.9%, p<0.01), OHT (67.0% vs 22.4%, p<0.001), and SE-IOP (41.1% vs 7.6%, p<0.001) were seen in the injection group compared to the age-matched control group. The rates of POAG and OHT were positively associated with the number of injections, R=0.856, P<0.01 and R=0.749, P<0.05, respectively.
Compared to age-matched controls, patients treated with anti-VEGF agents demonstrated an increased rate of OHT, SE-IOP, and POAG which correlated with the number of IVIs. However, additional prospective studies are needed to determine if there is a true association between intravitreal anti-VEGF injections and glaucoma.
通过与年龄匹配的对照组进行比较，研究抗血管内皮生长因子（VEGF）注射对高眼压症（OHT）、持续性眼压升高（SE-IOP）和原发性开角型青光眼（POAG）患病率的影响。
进行一项回顾性病例对照研究，以新生血管性年龄相关性黄斑变性（AMD）或糖尿病性黄斑水肿（DME）患者为研究组，以萎缩性AMD或无DME的糖尿病视网膜病变（DR）患者为对照组。治疗组使用贝伐单抗、雷珠单抗或两者联合使用。OHT定义为眼压>21 mmHg，而SE-IOP定义为眼压在间隔30天的两次或更多次就诊时升高>6 mmHg或>25 mmHg。排除有青光眼、静脉阻塞、玻璃体内注射类固醇和玻璃体切割术既往史的患者。
本研究共纳入784例患者的1312只眼。使用年龄匹配的对照组后，治疗组和对照组分别进一步细化为224例患者的394只眼和170例患者的340只眼。对照组的平均年龄为58.4±8.7岁，治疗组为58.8±8.8岁。注射组的平均眼压高于对照组，分别为25.8±9.3 mmHg和19.5±5.1 mmHg，P<0.001。与年龄匹配的对照组相比，注射组的POAG（10.7%对2.9%，p<0.01）、OHT（67.0%对22.4%，p<0.001）和SE-IOP（41.1%对7.6%，p<0.001）显著增加。POAG和OHT的发生率与注射次数呈正相关，R分别为0.856，P<0.01和0.749，P<0.05。
与年龄匹配的对照组相比，接受抗VEGF药物治疗的患者OHT、SE-IOP和POAG的发生率增加，且与玻璃体内注射次数相关。然而，需要更多的前瞻性研究来确定玻璃体内抗VEGF注射与青光眼之间是否存在真正的关联。
