Effects of Intravitreal Anti-VEGF Therapy on Glaucoma-like Progression in Susceptible Eyes

被引:22
|
作者
Du, Jeanette [1 ]
Patrie, James T. [2 ]
Prum, Bruce E. [3 ]
Netlana, Peter A. [3 ]
Shildkrot, Yevgeniy [3 ]
机构
[1] Univ Virginia, Sch Med, Charlottesville, VA 22908 USA
[2] Univ Virginia, Dept Publ Hlth Sci, Charlottesville, VA 22908 USA
[3] Univ Virginia, Dept Ophthalmol, 1300 Jefferson Pk Ave, Charlottesville, VA 22908 USA
关键词
anti-VEGF therapy; glaucoma; ocular hypertension; GROWTH-FACTOR THERAPY; INTRAOCULAR-PRESSURE; SUSTAINED ELEVATION; MACULAR DEGENERATION; RANIBIZUMAB; INJECTIONS; BEVACIZUMAB; PROPHYLAXIS; RISK;
D O I
10.1097/IJG.0000000000001382
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Precis: Intravitreal anti-vascular endothelial growth factor (VEGF) injections may accelerate glaucomatous change in patients with preexisting glaucoma or ocular hypertension (OHT). The safety of long-term injections in this specific population may be reflected in the need for additional glaucoma interventions. Purpose: The purpose of this study was to investigate whether repeated anti-VEGF injections accelerate structural and functional glaucomatous change in eyes with preexisting glaucoma or OHT. Materials and Methods: This is a retrospective, observational study of injected and noninjected fellow eyes. A total of 28 patients with preexisting glaucoma or OHT, who received >= 6 unilateral anti-VEGF injections for concurrent neovascular retinal disease, were selected for chart review. Primary outcome measures were rate of visual field loss in dB/year, rate of change in retinal nerve fiber layer (RNFL) thickness in microns/year, and need for additional glaucoma medications, surgery, or laser. Results: The number of eyes requiring additional glaucoma surgery or laser was 8 of 28 (28.6%) for the injected group and 2 of 28 (7.1%) for the noninjected group. A significantly greater proportion of injected eyes required invasive glaucoma intervention (P=0.034). Average rate of decline in mean deviation and change in pattern standard deviation were both significantly greater in injected eyes (P=0.029; P=0.019). Estimated mean rate of global retinal nerve fiber layer change was -4.27 mu m/y for the injected group and -1.17 mu m/y for the noninjected group and was significant only for injected eyes (P=0.014). Only the superior quadrant exhibited thinning that was significantly different between groups (P=0.030). Conclusions: Intravitreal injections were associated with accelerated functional and structural glaucoma-like change in susceptible eyes. Clinicians should assess the need for glaucoma medications or other interventions over the course of anti-VEGF therapy.
引用
收藏
页码:1035 / 1040
页数:6
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