Analysis of Intraocular Pressure Elevation after Intravitreal Injection of Ranibizumab and Aflibercept

Tae Kyu Moon; Jun Young Ha; Mi Sun Sung; Sang Woo Park

doi:10.3341/jkos.2019.60.4.362

Journal List > J Korean Ophthalmol Soc > v.60(4) > 1120598

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Moon, Ha, Sung, and Park: Analysis of Intraocular Pressure Elevation after Intravitreal Injection of Ranibizumab and Aflibercept

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(4): 362-368.

Published online: 17 April 2019

DOI: https://doi.org/10.3341/jkos.2019.60.4.362

Analysis of Intraocular Pressure Elevation after Intravitreal Injection of Ranibizumab and Aflibercept

Tae Kyu Moon, MD, Jun Young Ha, MD, Mi Sun Sung, MD, PhD, Sang Woo Park, MD, PhD

Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea.

Address reprint requests to Sang Woo Park, MD, PhD. Department of Ophthalmology, Chonnam National University Medical School, #42 Jebong-ro, Dong-gu, Gwangju 61469, Korea. Tel: 82-62-220-6753, Fax: 82-62-227-1642, exo70@naver.com

Received 26 July 2018 Revised 8 November 2018 Accepted 18 March 2019

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate long-term intraocular pressure (IOP) and risk of IOP elevation after intravitreal injection of ranibizumab or aflibercept in patients with age-related macular degeneration (AMD).

Methods

From January 2013 to December 2016, we retrospectively reviewed patients who underwent intravitreal ranibizumab or aflibercept injections for AMD. IOP was measured before injection and 1 week, 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, 9 months, and 1 year after injection. Sustained IOP elevation was defined when the final IOP increased by 6 mmHg more than the pre-injection IOP, and when there were two consecutively measured values > 21 mmHg. The risk factors were then analyzed.

Results

Using Kaplan-Meier survival analysis, sustained IOP elevation occurred in 9 of 80 eyes (11.3%) in 1 year, and the mean survival time was 11.50 months after injection. Five eyes (12.8%) of the ranibizumab group and four eyes (9.8%) of the aflibercept group had mean survival times of 11.39 and 11.61 months, respectively. The log-rank test showed no significant difference between the two groups (p = 0.659). A significant risk factor for sustained IOP elevation was a history of primary open-angle glaucoma (p = 0.035).

Conclusions

The incidence of sustained IOP elevation was not significantly different between the two groups. Clinicians should therefore carefully monitor the IOP before and after intravitreal ranibizumab or aflibercept injections, especially in AMD patients with primary open-angle glaucoma.

Keywords: Aflibercept, Intraocular pressure, Intravitreal injection, Ranibizumab

Figures and Tables

Figure 1

Cumulative probability of the sustained IOP elevation of total 80 eyes by Kaplan-Meier survival analysis. Events occurs in 9 eyes of 80 eyes, and survival rate of sustained IOP elevation was 88.8% at 12 months. Mean survival time was 11.50 months. IOP = intraocular pressure.

Figure 2

Cumulative probability of the sustained IOP elevation in ranibizumab group and aflibercept group by Kaplan-Meier survival analysis. Events occurs in 5 eyes in ranibizumab group and 4 eyes in aflibercept group. Survival rate of sustained IOP elevation was 87.2% in ranibizumab group and 90.2% in aflibercept group at 12 months. Mean survival time was 11.39 month in ranibizumab group and 11.61 month in aflibercept group. IOP = intraocular pressure.

Table 1

Baseline characteristics of ranibizumab group and aflibercept group

Values are presented as mean ± standard deviation or number (%) unless otherwise indicated.

POAG = primary open angle glaucoma; IOP = intraocular pressure.

^*Student t-test; ^†chi-square test or a Fisher's exact test.

Table 2

Risk factors for sustained IOP elevation after intravitreal ranibizumab or aflibercept injection

IOP = intraocular pressure; anti-VEGF = anti-vascular endothelial growth factor; POAG = primary open angle glaucoma.

^*Cox proportional hazards analysis.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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