Research Article
Intravitreal Ranibizumab/ Lucentis (IVTL) injections in Glaucoma patients-Intraocular Pressure (IOP) elevation and the use of Anterior Chamber Paracentesis (ACP)
EA Ansari* and H Huraira
Published: 09/20/2017 | Volume 1 - Issue 1 | Pages: 033-041
Abstract
Purpose
• To assess the short term effects of intravitreal Lucentis (IVTL) on intraocular pressure in patients with ocular hypertension and glaucoma.
• To determine rate of anterior chamber paracentesis (ACP) required post-injection according to departmental protocol.
Methods
This was a prospective, observational study carried out between August 2011 and February 2012 in the Department of Ophthalmology, Maidstone Hospital. 24 participants (13 female, 11 male) with established ocular hypertension (OHT) or glaucoma were chosen from a cohort of patients receiving intravitreal (IVTL) Ranibizumab (Lucentis) treatment for wet age related macular degeneration (wARMD). Apraclonidine 1% was given pre-injection, and baseline IOP was measured 30 min. after this, just before IVTL. IOP was measured at baseline, within 1 min of injection, 5 min, 15 min, 30 min up to 60min following a single IVTL treatment.
Anterior paracentesis was performed if:
• Immediate post injection IOP > 50mm Hg and OHT.
• Immediate post injection IOP > 40 mm Hg and there was evidence of disc damage only.
• Immediate post injection IOP > 30mm Hg with evidence of disc damage and visual field loss.
• Immediate post injection IOP > 30mm Hg with evidence of disc damage and visual field loss
Read Full Article HTMLDOI: 10.29328/journal.hceo.1001005Cite this Article
References
- Kvanta A, Algvere PV, Berglin L, Seregard S. Subfoveal fibrovascular membranes in age related macular degeneration express vascular endothelial growth factor. Invest Ophthalmol Vis Sci. 1996; 37: 1929-1934. Ref.: https://goo.gl/1thLnq
- Shams N, Ianchulev T. Role of vascular endothelial growth factor in ocular angiogenesis. Ophthalmol Clin North Am. 2006; 19: 335-344. Ref.: https://goo.gl/Wu4JFG
- Bressler SB. Introduction: understanding the role of angiogenesis and antiangiogenic agents in age-related macular degeneration. Ophthalmology. 2009; 116: S1-S7. Ref.: https://goo.gl/Ffvuky
- Package insert. Avastin (Bevacizumab). San Francisco: Genentech, 2004.
- Package insert. Lucentis (Ranibizumab). San Francisco: Genentech, 2006.
- Zondor SD, Medina PJ. Bevacizumab: an angiogenesis inhibitor with efficacy in colorectal and other malignancies. Ann Pharmacother. 2004; 38: 1258-1264. Ref.: https://goo.gl/ez9Qk8
- Bressler NM. Antiangiogenic approaches to age-related macular degeneration today. Ophthalmology. 2009; 116: S15-S23. Ref.: https://goo.gl/MWv72s
- Rich RM, Rosenfeld PJ, Puliafito CA. Short-term safety and efficacy of intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration. Retina. 2006; 26: 495-511. Ref.: https://goo.gl/5RCmZv
- Fung AE, Rosenfeld PJ, Reichel E. The International intravitreal bevacizumab safety survey: using the internet to assess drug safety worldwide. Br J Ophthalmol. 2006; 90: 1344-1349. Ref.: https://goo.gl/3u7tYn
- Gordon A, Maximiliano M. Bevacizumab local complications. Ophthalmology. 2009; 116: 2264. Ref.: https://goo.gl/utdoR4
- Jalil A, Fenerty C, Charles S. Intravitreal bevacizumab (Avastin) causing acute glaucoma: an unreported complication. Eye (Lond). 2007; 21: 1541. Ref.: https://goo.gl/PfJa8j
- Zheng Q, Mayer H, Adelman RA. Persistent ocular hypertension following multiple intravitreal Anti-VEGF Injections for AMD. Invest Ophthalmol Vis Sci. 2009; 50: 959. Ref.: https://goo.gl/GVLoHd
- Bakri SJ, McCannel CA, Edwards AO. Persistent ocular hypertension following intravitrea ranibizumab. Graefes Arch Clin Exp Ophthalmol. 2008; 246: 955-958. Ref.: https://goo.gl/wwEcRJ
- Kahook MY, Kimura AE, Wong LS. Sustained elevation of intraocular pressure associated with intravitreal bevacizumab injections. Ophthalmic Surg Lasers Imaging. 2009; 40: 293-295. Ref.: https://goo.gl/WznkVq
- Good TJ, Kimura AE, Mandava N, Kahook MY. Sustained elevation of intraocular pressure after intravitreal injections of anti-VEGF agents. Br J Ophthalmol. 2011; 95: 1111-1114. Ref.: https://goo.gl/2Fc6GL
- Rashid A, Quhill F, Pushpoth S. Effect of Iopidine administration prior to intravitreal Lucentis injection on intraocular pressure spike. Invest Ophthalmol Vis Sci. 2009; 50. Ref.: https://goo.gl/N9LQN1
- El Chehab H, Le Corre A, Giraud JM. Efficacy of prophylactic treatment of intraocular pressure spikes due to intravitreal injections. J Fr Ophtalmol. 2012; 35: 614-621. Ref.: https://goo.gl/ovKRSE
- Fortune B, Burgoyne CF, Cull GA. Structural and functional abnormalities of retinal ganglion cells measured in vivo at the onset of optic nerve head surface change in experimental glaucoma. Invest Ophthalmol Vis Sci. 2012; 53: 3939-3950. Ref.: https://goo.gl/JpYkWP
- The Advanced Glaucoma Intervention Study (AGIS): 7. The Relationship Between Control of Intraocular Pressure and Visual Field Deterioration THE AGIS INVESTIGATORS. Am J Ophthalmol. 2000; 130: 429-440. Ref.: https://goo.gl/thpmvq
- Carver J, Bouska C, Corey R. Avastin and risk of glaucoma [abstract]. New York: Retina Congress, 2009.
- Frenkel MP, Haji SA, Frenkel RE. Effect of prophylactic intraocular pressure lowering medication on intraocular spikes after intravitreal injections. Arch Ophthalmol. 2010; 128: 1523-1527. Ref.: https://goo.gl/G2YmUr
- Kim JE, Mantravadi AV, Hur EY, Covert DJ. Short term intraocular pressure changes immediately after intravitreal injections of anti-vascular endothelial growth factor agents. Am J Ophthalmol. 2008; 146: 930-934. Ref.: https://goo.gl/Tey8J2
- Hollands H, Wong J, Bruen R, Campbell RJ, Sharma S. Short-term intraocular pressure changes after intravitreal injection of bevacizumab. Can J Ophthalmol. 2007; 42: 807-811. Ref.: https://goo.gl/iUWVVg
- Sharei V, Hohn F, Kohler T, Hattenbach LO, Mirshahi A. Course of intraocular pressure after intravitreal injection of 0.05mL ranibizumab (Lucentis). Eur J Ophthalmol. 2010; 20: 174-179. Ref.: https://goo.gl/15oqcJ
- Gismondi M, Salati C, Salvetat ML, Zeppieri M, Brusini P. Short-term effect of intravitreal injection of Ranibizumab (Lucentis) on intraocular pressure. J Glaucoma. 2009; 18: 658-661. Ref.: https://goo.gl/9ZNRnV
- Usman SM, Batra R, Qureshi F, Clark D. Reflux of drug during intravitreal anti-VEGF therapies. Semin Ophthalmol. 2011; 26: 357-360. Ref.: https://goo.gl/Dbng6T
- Arikan G, Osman SA, Hakan OF. Immediate intraocular pressure rise after intravitreal injection of ranibizumab and two doses of triamcinolone acetonide. Int J of Ophthal. 2011; 4: 402-405. Ref.: https://goo.gl/iy8jj2
- Kahook MY, Liu L, Ruzycki P. High-molecular-weight aggregates in repackaged bevacizumab. Retina. 2010; 30: 887-892. Ref.: https://goo.gl/9B4iji
- Nabili S, Stevenson M, Chakravarty U. Short-term effect of intravitreal anti-VEGFs delivery on intraocular pressure. Br J Ophthalmol. 2009; 93: 552–553. Ref.: https://goo.gl/1By6KZ
- Drance SM. The significance of the diurnal tension variations in normal and glaucomatous eyes. Arch Ophthalmol. 960; 64: 494-501. Ref.: https://goo.gl/XHdVi7
- Stewart WC, Chorak RP, Hunt HH, Sethuraman G. Factors associated with visual loss in patients with advanced glaucomatous changes in the optic nerve head. Am J Ophthalmol. 1993; 116: 176-181. Ref.: https://goo.gl/FhSTBx
- Tranos P, Bhar G, Little B. Postoperative intraocular pressure spikes: the need to treat. Eye(Lond). 2004: 673-679. Ref.: https://goo.gl/aBbJcp
- Buono LM, Foroozan R, Sergott RC, Savino PJ. Nonarteritic anterior ischemic optic neuropathy. Curr Opin Ophthalmol. 2002; 13: 357-361. Ref.: https://goo.gl/ugH8z4
- Basile C, Addabbo G, Montanaro A. Anterior ischemic optic neuropathy and dialysis: role of hypotension and anemia. J Nephrol. 2001; 14: 420-423. Ref.: https://goo.gl/XruK3z
- Koker AE. Visual prognosis in advanced glaucoma: a comparison of medical and surgical therapy for retention of vision in 101 eyes with advanced glaucoma. Trans Am OphthalmolSoc. 1977; 75: 539-555. Ref.: https://goo.gl/XBLkvi
- Savage JA, Thomas JV, Belcher III CD. Extracapsular cataract extraction and posterior chamber intraocular lens implantation in glaucomatous eyes. Ophthalmology. 1985; 92: 1506-1516. Ref.: https://goo.gl/aoTPUh
- Colotto A, Falsini B, Salgarello T, et al. Transiently raised intraocular pressure reveals pattern electroretinogram losses in ocular hypertension. Invest Ophthalmol Vis Sci. 1996; 37: 2663-2670. Ref.: https://goo.gl/qRD2U1
- Chan KC, Poostchi A, Wong T, et al. Visual field changes after transient elevation of intraocular pressure in eyes with and without glaucoma. Ophthalmology. 2008; 115: 667-672. Ref.: https://goo.gl/A8J4xv
- Yandan Zhou, Minwen Zhou, Shigang Xia, et al. Sustained Elevation of Intraocular Pressure Associated with Intravitreal Administration of Anti-vascular Endothelial Growth Factor: A Systematic Review and Meta-Analysis. Sci Rep. 2016; 6: 39301. Ref.: https://goo.gl/cQepW1
- Freund, K.B, Hoang, Q.V, Saroj N, Thompson D. Intraocular Pressure in Patients with Neovascular Age-Related Macular Degeneration Receiving Intravitreal Aflibercept or Ranibizumab. Ophthalmology. 2015; 122: 1802-1810. Ref.: https://goo.gl/eoKt2c
































