Intraocular pressure effects of pegaptanib (Macugen) injections in patients with and without glaucoma

Purpose: To determine if pegaptanib (Macugen) [Eyetech Pharmaceuticals; Pfizer Inc, New York, New York, USA] injections cause adverse intraocular pressure (IOP) effects in patients with and without glaucoma. Design: Retrospective chart review. Methods: Review of 75 eyes treated with intravitreal injections of pegaptanib (0.09 ml). The effect of these injections on IOP was analyzed. Most patients received prophylactic IOP-lowering medications. Results: The mean preinjection IOP based on the first injection of each patient was 14 +/- 3 mm Hg; at one minute postinjection, 38 +/- 14 min Hg, at three to 10 minutes was 34 +/- 9 mm Hg, and at 11 to 20 minutes was 26 +/- 10 mm Hg, respectively. Most patients' IOPs had significantly diminished by 30 minutes postinjec- tion. Conclusion: Pegaptanib injections result in a significant transient rise in IOP that considerably diminishes by 30 minutes postinjection but can take up to one hour. This may be damaging to the optic nerve, particularly in patients with advanced glaucoma.