Evaluation of intraocular pressure elevation after multiple injections of intravitreal ranibizumab

摘要

Background: We wanted to determine whether multiple injections of intravitreal ranibizumab was associated with an elevated intraocular pressure (IOP) in patients treated for neovascular age-related macular degeneration (AMD).Methods: This retrospective study examined 53?patients with neovascular AMD treated with multiple injections of intravitreal ranibizumab. The main outcome measure was the difference in IOP between the frequently-treated study eyes (≥15?injections) and the unfrequently-treated fellow control eyes (≤ five injections). Patients were divided into three study groups: group?I (35?patients with 15?to 19?injections); group II (15?patients with 20?to 29?injections); and group?III (three patients with ≥30?injections). The IOP was measured by Goldmann applanation tonometry 4?weeks after the last injection of intravitreal ranibizumab. For statistical analysis, the IOP was then correlated with the number of ranibizumab injections.Results: Among the frequently-treated study eyes, the mean IOP was 13.68±2.91?mmHg (range, 8?to 20?mmHg). The unfrequently-treated fellow control eyes had a mean IOP of 13.45±3.09?mmHg (range, 9?to 25?mmHg). There was no significant correlation of the IOP difference between the study and control eyes with the number of ranibizumab injections (correlation coefficient 0.77; P=0.583). For each of groups I, II, and III, the difference in mean IOP between the study and control eyes was nonsignificant (P>0.05). There was also no significant association of the IOP difference between the study and control eyes with the number of ranibizumab injections for each group (P=0.391).Conclusion: Our study did not find an increased IOP in frequently-ranibizumab-treated eyes when compared to unfrequently-treated fellow control eyes. Further studies with a greater sample size are needed to evaluate whether an increased number of ranibizumab injections is associated with IOP changes.