Immediate Intraocular Pressure Rise After Intravitreal Injection of Ranibizumab and Two Doses of Triamcinolone Acetonide

Overview

Journal Int J Ophthalmol

Specialty Ophthalmology

Date 2012 May 4

PMID 22553690

Citations 19

Authors

Gul Arikan

Ali Osman Saatci

Ferit Hakan Oner

Affiliations

Soon will be listed here.

Abstract

Aim: To evaluate prospectively immediate intraocular pressure (IOP) changes after the intravitreal injection of ranibizumab, 2 and 4mg triamcinolone acetonide.

Methods: Patients who underwent intravitreal injection of 0.1mL (4mg) triamcinolone acetonide (TA, Group T4), 0.05mL (2mg) TA (Group T2) and 0.05mL (0.5mg) ranibizumab (Group R) comprised the study population. Overall, 229 eyes of 205 patients were injected. Fifty-four eyes (23.6%) were in Group T4, 69 eyes (30.1%) in Group T2 and 106 eyes (46.3%) in Group R. If IOP was less than 26mmHg immediately after the injection no further measurement was performed. If IOP was ≥26mmHg, IOP was remeasured till the reading was below 26mmHg at 5, 15 and 30 minutes.

Results: Immediately after the injection, the IOP of 28 eyes (51.9%) in Group T4, 22 eyes (31.9%) in Group T2 and 51 eyes (48.1%) in Group R were over 25mmHg. At 30 minutes, IOP of one eye (1.9%) in group T4, two eyes (2.9%) in group T2 and two eyes (1.9 %) in Group R were over 25mmHg. Immediate post-injection IOP was significantly higher in Group T4 and Group R when compared to Group T2 (P<0.001 and P<0.001, respectively). IOP was significantly higher in eyes without vitreous reflux when compared to those with vitreous reflux in all groups (P<0.001).

Conclusion: IOP may remarkably increase immediately after the intravitreal injection of 2 or 4mg triamcinolone acetonide, and 0.5mg ranibizumab. Absence of vitreous reflux is the most important predicting factor for immediate IOP rise after the injection.

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References

Rosenfeld P, Brown D, Heier J, Boyer D, Kaiser P, Chung C . Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006; 355(14):1419-31. DOI: 10.1056/NEJMoa054481. View

Dwinger M, Pieper-Bodeewes I, Eter N, Holz F . [Variations in intraocular pressure (IOP) and necessity for paracentesis following intravitreal triamcinolone injection]. Klin Monbl Augenheilkd. 2005; 222(8):638-42. DOI: 10.1055/s-2005-858459. View

Kotliar K, Maier M, Bauer S, Feucht N, Lohmann C, Lanzl I . Effect of intravitreal injections and volume changes on intraocular pressure: clinical results and biomechanical model. Acta Ophthalmol Scand. 2007; 85(7):777-81. DOI: 10.1111/j.1600-0420.2007.00939.x. View

Benz M, Albini T, Holz E, Lakhanpal R, Westfall A, Iyer M . Short-term course of intraocular pressure after intravitreal injection of triamcinolone acetonide. Ophthalmology. 2006; 113(7):1174-8. DOI: 10.1016/j.ophtha.2005.10.061. View

Hauser D, Bukelman A, Pokroy R, Katz H, Len A, Thein R . Intravitreal triamcinolone for diabetic macular edema: comparison of 1, 2, and 4 mg. Retina. 2008; 28(6):825-30. DOI: 10.1097/IAE.0b013e318165767e. View

Falkenstein I, Cheng L, Freeman W . Changes of intraocular pressure after intravitreal injection of bevacizumab (avastin). Retina. 2007; 27(8):1044-7. DOI: 10.1097/IAE.0b013e3180592ba6. View

Hollands H, Wong J, Bruen R, Campbell R, Sharma S, Gale J . Short-term intraocular pressure changes after intravitreal injection of bevacizumab. Can J Ophthalmol. 2007; 42(6):807-11. DOI: 10.3129/i07-172. View

Gillies M, Simpson J, Billson F, Luo W, Penfold P, Chua W . Safety of an intravitreal injection of triamcinolone: results from a randomized clinical trial. Arch Ophthalmol. 2004; 122(3):336-40. DOI: 10.1001/archopht.122.3.336. View

Rhee D, PECK R, Belmont J, Martidis A, Liu M, Chang J . Intraocular pressure alterations following intravitreal triamcinolone acetonide. Br J Ophthalmol. 2006; 90(8):999-1003. PMC: 1857192. DOI: 10.1136/bjo.2006.090340. View

10.

Wu H, Chen T . The effects of intravitreal ophthalmic medications on intraocular pressure. Semin Ophthalmol. 2009; 24(2):100-5. DOI: 10.1080/08820530902800397. View

11.

Frenkel R, Mani L, Toler A, Frenkel M . Intraocular pressure effects of pegaptanib (Macugen) injections in patients with and without glaucoma. Am J Ophthalmol. 2007; 143(6):1034-5. DOI: 10.1016/j.ajo.2007.01.052. View

12.

Vasconcelos-Santos D, Nehemy P, Schachat A, Nehemy M . Secondary ocular hypertension after intravitreal injection of 4 mg of triamcinolone acetonide: incidence and risk factors. Retina. 2008; 28(4):573-80. DOI: 10.1097/IAE.0b013e31816079e8. View

13.

Gismondi M, Salati C, Salvetat M, Zeppieri M, Brusini P . Short-term effect of intravitreal injection of Ranibizumab (Lucentis) on intraocular pressure. J Glaucoma. 2009; 18(9):658-61. DOI: 10.1097/IJG.0b013e31819c4893. View

14.

Inatani M, Iwao K, Kawaji T, Hirano Y, Ogura Y, Hirooka K . Intraocular pressure elevation after injection of triamcinolone acetonide: a multicenter retrospective case-control study. Am J Ophthalmol. 2008; 145(4):676-681. DOI: 10.1016/j.ajo.2007.12.010. View

15.

Cho Y . Early intraocular pressure and anterior chamber depth changes after phacoemulsification and intraocular lens implantation in nonglaucomatous eyes. Comparison of groups stratified by axial length. J Cataract Refract Surg. 2008; 34(7):1104-9. DOI: 10.1016/j.jcrs.2008.03.023. View

16.

Sharei V, Hohn F, Kohler T, Hattenbach L, Mirshahi A . Course of intraocular pressure after intravitreal injection of 0.05 mL ranibizumab (Lucentis). Eur J Ophthalmol. 2009; 20(1):174-9. DOI: 10.1177/112067211002000124. View

17.

Kerimoglu H, Ozturk B, Bozkurt B, Okka M, Okudan S . Does lens status affect the course of early intraocular pressure and anterior chamber changes after intravitreal injection?. Acta Ophthalmol. 2009; 89(2):138-42. DOI: 10.1111/j.1755-3768.2009.01656.x. View

18.

Kim J, Mantravadi A, Hur E, Covert D . Short-term intraocular pressure changes immediately after intravitreal injections of anti-vascular endothelial growth factor agents. Am J Ophthalmol. 2008; 146(6):930-4.e1. DOI: 10.1016/j.ajo.2008.07.007. View

19.

Bakri S, Pulido J, McCannel C, Hodge D, Diehl N, Hillemeier J . Immediate intraocular pressure changes following intravitreal injections of triamcinolone, pegaptanib, and bevacizumab. Eye (Lond). 2007; 23(1):181-5. DOI: 10.1038/sj.eye.6702938. View

20.

Jonas J, Degenring R, Kreissig I, Akkoyun I, Kamppeter B . Intraocular pressure elevation after intravitreal triamcinolone acetonide injection. Ophthalmology. 2005; 112(4):593-8. DOI: 10.1016/j.ophtha.2004.10.042. View