Incidence of elevated intraocular pressure after intravitreal injection in Japanese patients with age-related macular degeneration

AbstractThe purpose of this study was to report the incidence of elevated intraocular pressure (IOP) after intravitreal injection (IVI) of anti-vascular endothelial growth factor (VEGF) in Japanese patients with age-related macular degeneration (AMD). A retrospective study of chart review of patients who underwent ≥ 10 intravitreal anti-VEGF injections between April 2009 and December 2019 was conducted. Elevated IOP was defined as IOP ≥ 25 mmHg at one visit. Cases with elevated IOP resulting from IVI were identified. Furthermore, the association between elevated IOP and some parameters, as the risk factors that influence elevated IOP, was investigated. A total of 402 eyes of 370 patients were included in this study. Twenty-eight eyes of 26 patients (7.0%) were identified as cases with elevated IOP after IVI. The mean time of elevation after baseline was 50.6 ± 26.5 months. History of glaucoma (p = 0.021; odds ratio, 5.85), treatment modality (p = 0.019; odds ratio, 6.32), and total number of injections (p = 0.003; odds ratio, 1.03) were significantly associated with elevated IOP. A late complication of elevated IOP is associated with IVI in patients with AMD. Particularly, history of glaucoma and treat and extend regimen with frequent injections were found to be risk factors of elevated IOP.

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Risk factors for emerging intraocular inflammation after intravitreal brolucizumab injection for age-related macular degeneration

PLoS ONE ◽

10.1371/journal.pone.0259879 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0259879

Author(s):

Ryo Mukai ◽

Hidetaka Matsumoto ◽

Hideo Akiyama

Keyword(s):

Risk Factors ◽

Macular Degeneration ◽

Odds Ratio ◽

Vascular Occlusion ◽

Intraocular Inflammation ◽

Age Related Macular Degeneration ◽

Age Related ◽

Significant Difference ◽

Potential Risk Factors ◽

History Of

Purpose To analyze the risk factors associated with emerging intraocular inflammation (IOI) after intravitreal brolucizumab injection (IVBr) to treat age-related macular degeneration (AMD). Methods This study included 93 eyes of 90 patients. The incidence of emerging IOI was analyzed. The patients were classified into IOI or non-IOI groups, and background clinical characteristics in each group were compared. Results IOI occurred in 14 eyes of 14 cases (16%; five women, nine men [5:9]; IOI group) after IVBr; contrastingly, no IOI occurred in 76 patients (10 women, 66 men [10:66]; non-IOI group). The mean ages in IOI and non-IOI groups were 79.4 ± 8.1 and 73.8 ± 8.9 years old, respectively, and the average age in the IOI group was significantly higher than that in the non-IOI group (P = 0.0425). In addition, the percentages of females in the IOI and non-IOI groups were 43% and 13%, respectively, and IOI occurred predominantly in females (odds ratio: 4.95, P = 0.0076). Moreover, the prevalence of diabetes in the IOI and non-IOI groups was 64% and 32%, respectively, with a significant difference (odds ratio: 3.90, P = 0.0196). In contrast, the prevalence of hypertension in the IOI and non-IOI groups was 36% and 57%, respectively, with no significant difference (P = 0.15). Conclusion The comparison of clinical profiles of IOI or non-IOI cases in IVBr treatment for AMD suggests that the risk factors for IOI are old age, female sex, and history of diabetes; however, IOI with vasculitis or vascular occlusion in this cohort does not seem to cause severe visual impairment. Further studies are required to investigate potential risk factors for IOI.

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Prevalence and characteristics of macular atrophy in eyes with neovascular age-related macular degeneration. A study from a long-term observational dataset: the Fight Retinal Blindness! project

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-315055 ◽

2019 ◽

Vol 104 (8) ◽

pp. 1064-1069

Author(s):

Vincent Daien ◽

Vuong Nguyen ◽

Rohan W Essex ◽

Robin Guymer ◽

Jennifer J Arnold ◽

...

Keyword(s):

Risk Factors ◽

Macular Degeneration ◽

Cross Sectional Study ◽

Age Related Macular Degeneration ◽

Vegf Inhibitors ◽

Cross Sectional ◽

Macular Atrophy ◽

Anti Vegf ◽

Age Related ◽

History Of

BackgroundTo assess the prevalence and characteristics associated with macular atrophy (MA) in eyes with neovascular age-related macular degeneration (nAMD) treated with vascular endothelial growth factor (VEGF) inhibitors.MethodsThis was a retrospective, cross-sectional study of nAMD eyes that commenced anti-VEGF between January 2006 and August 2016. MA (absent/extrafoveal/subfoveal) was graded by treating practitioners based on multimodal imaging from April 2016. The prevalence of MA over time and risk factors of MA were assessed.ResultsThe prevalence of MA in a cohort of 1689 eyes was 9.9% (22/222) in eyes within 1 year of starting treatment, 41.5% (71/171) after 5 years and 48.4% (30/62) after 9 years of treatment. Risk factors for subfoveal MA included the proportion of visits at which the lesion was graded as inactive ((adjusted OR (AOR) 3.72 for the highest vs lowest the quartile of frequency of inactive gradings (95% CI 2.33 to 6.07)), age (AOR 1.05 per year (95% CI 1.02 to 1.07)), baseline visual acuity (AOR 3.9 for ≤35 letters vs ≥70 letters (95% CI 2.4 to 6.4)) and the number of injections received (AOR 1.20 every 10 injections (95% CI 1.08 to 1.33)). Similar associations were observed with extrafoveal MA.ConclusionsThe risk of MA appeared to drop in eyes that had not developed it within 5 years. Low choroidal neovascularisation activity was by far the strongest predictor. We could not determine whether the increased prevalence of MA with time was due to anti-VEGF treatment or the natural history of the condition.

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Diabetes and other risk factors in patients with age-related macular degeneration

Romanian Journal of Diabetes Nutrition and Metabolic Diseases ◽

10.2478/rjdnmd-2013-0036 ◽

2013 ◽

Vol 20 (4) ◽

pp. 369-378

Author(s):

Valeria Mocanu ◽

Rózsa Dégi ◽

Andrea Facskó ◽

Eszter Vizvári ◽

Raluca Horhat ◽

...

Keyword(s):

Risk Factors ◽

Macular Degeneration ◽

Smoking Status ◽

Age Related Macular Degeneration ◽

Ophthalmological Examination ◽

Age Related ◽

Potential Risk Factors ◽

History Of ◽

Optical Coherence Tomograph ◽

Sd Oct

Abstract Background and aims: Our aim was to evaluate the association between the potential risk factors and the different stages of age-related macular degeneration (AMD) in a population aged 52-85 years. Material and methods: One hundred and ten patients with different stages of AMD were evaluated by direct interview for identifying possible present factors risk and were subjected to a detailed ophthalmological examination, including measurement of the macular area by the Spectral Domain-Optical Coherence Tomograph Heidelberg Engineering (SD-OCT). For the grading of AMD we used the International Classification and Grading System for Age-Related Maculopathy. Results: In our study, diabetes, arterial hypertension, dyslipidemia and smoking were risk factors for AMD. A longer history of diabetes or smoking status was associated with stage 3 or 4 of AMD. We found no statistical significant association between pseudophakia and AMD. Conclusions: Further investigation is needed to identify and to clarify the association between these possible risk factors and AMD.

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Therapeutic effect of Ranibizumab combined with Triamcinolone Acetonide on wet age-related macular degeneration and its effect on interleukin

Discussion of Clinical Cases ◽

10.5430/dcc.v7n2p18 ◽

2020 ◽

Vol 7 (2) ◽

pp. 18

Author(s):

Xiaohong Sheng ◽

Xiangyang Xin ◽

Liming Wang ◽

Yan Sun ◽

Xiaohua Li

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Macular Degeneration ◽

Intravitreal Injection ◽

Triamcinolone Acetonide ◽

Repeated Measures ◽

Age Related Macular Degeneration ◽

Combination Group ◽

Age Related ◽

Wet Amd

Objective: To observe the clinical efficacy of ranibizumab combined with triamcinolone acetonide on wet age-related macular degeneration (AMD) and explore the effect of this method on the levels of IL-1, IL-2, IL-6 and IL-8.Methods: Prospective study was conducted in this research. 86 cases of patients with wet AMD (102 eyes) admitted in Baogang Hospital of Inner Mongolia from November 2017 to October 2018 were chosen and randomly divided into the ranibizumab group (43 cases, 50 eyes) and the combination group (43 cases, 52 eyes). The ranibizumab group of patients were given intravitreal injection of ranibizumab, and the combination group was additionally given triamcinolone acetonide on the basis of the ranibizumab group. The intraocular pressure values of the two groups before treatment, in 2 weeks, 1 month and 3 months after treatment were compared. The central macular thickness (CMT) and visual acuity of the two groups before treatment as well as in 1 month, 3 months and 6 months after treatment were compared. The levels of IL-1, IL-2, IL-6 and IL-8 in the serum were compared between the two groups before treatment and in 1 month after treatment. The incidences of complications during treatment in the two groups were recorded and compared. The data were analyzed by use of t-test, repeated measures ANOVA and χ2 test.Results: There were no statistically significant differences in intraocular pressure value between the two groups (Fgroups = 1.275, p = .496; Ftime = 1.810, p = .211; Finteraction = 1.772, p = .335). There were no statistically significant differences in CMT and visual acuity before treatment between the two groups (t = 0.042, p = .967; t = 0.720, p = .473). In one month, three months and six months after treatment, CMT in the combined group was lower than that in the ranibizumab group (t = 2.086, p = .039; t = 3.398, p = .001; t = 2.987, p = .004), and the visual acuity of the combined group was higher than that of the ranibizumab group (t = 3.265, p = .001; t = 2.217, p = .029; t = 2.519, p = .013). CMT showed a decreasing tendency (tbefore treatment vs. t1 month after treatment = 6.210, 4.218, p < .001; t1 month after treatment vs. t3months after treatment = 16.772, 15.865, p < .001; t3 months after treatment vs. t6 months after treatment = 4.472, 4.848, p < .001) and the visual acuity showed an increasing trend (tbefore treatment vs. t1 month after treatment = 4.527, 8.395, p < .001; t1 month after treatment vs. t3 months after treatment = 5.369, 5.349, p < .001; t3 months after treatment vs. t6 months after treatment = 3.335, 3.730, p < .001) with the time going by in the two groups. Compared with the indicators before treatment, the levels of IL-1_, IL-6 and IL-8 in the serum in 1 month after treatment were lower in both two groups (tcombination group = 10.544, 32.169, 33.156, all p < .001; tranibizumab group = 8.996, 25.687, 30.754, all p < .001), and these indicators in the combination group were lower than those in the ranibizumab group (t = 2.894, p = .005; t = 5.997, p < .001; t = 3.934, p < .001). Compared with the indicators before treatment, the levels of IL-2 in the serum in 3 months after treatment in the two groups were higher (t = 20.067, 9.091, all < .001), and the indicator in the combination group was higher than that in the ranibizumab group (t = 7.705, p < .001). There were no statistically significant differences in the incidences of bleeding, intraocular foreign body sensation and transient high IOP and the total incidence of complications between the two groups (correction χ2 = 0.001, p = .972; correction χ2 = 0.221, p = .638; Fisher’s exact test p = .116; correction χ2 = 0.004, p = .951).Conclusions: Intravitreal injection of ranibizumab combined with triamcinolone acetonide can effectively improve the visual function of wet AMD, reduce CMT and the levels of IL-1, IL-6 and IL-8 in the serum, increase the level of IL-2 in the serum and relieve the degree of inflammatory responses.

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Lutein as a Contributing Modulator of Age-related Macular Degeneration

US Ophthalmic Review ◽

10.17925/usor.2012.05.01.57 ◽

2012 ◽

Vol 05 (01) ◽

pp. 57

Author(s):

Clyde Schultz ◽

Keyword(s):

Risk Factors ◽

Body Weight ◽

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Leafy Vegetables ◽

Green Leafy Vegetables ◽

Age Related ◽

History Of ◽

Available Information ◽

Oral Supplement

Lutein is a small-molecule carotenoid that has been studied with varying degrees of interest in both general nutrition and ophthalmology. This molecule is derived from green leafy vegetables (as well as commercially available dietary supplements) and has been postulated to act as a modulator in retinal health, specifically as a factor in the prevention of macular degeneration. The available clinical data do not suggest that lutein or the carotenoid zeaxanthin have any inherent toxicity. The presence of either or both has been linked to the prevention, but not necessarily the treatment, of macular degeneration. The available information may suggest that lutein intake as an oral supplement, coupled with awareness (and where possible modulation) of certain risk factors such as elevated body weight, smoking, and a family history of AMD, taken as part of an entire personalized treatment regimen, could positively impact the development of age-related macular degeneration.

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Age-Related Macular Degeneration in Nepal

Kathmandu University Medical Journal ◽

10.3126/kumj.v9i3.6298 ◽

2012 ◽

Vol 9 (3) ◽

pp. 165-169 ◽

Cited By ~ 5

Author(s):

R Thapa ◽

G Paudyal ◽

M K Shrestha ◽

R Gurung ◽

S Ruit

Keyword(s):

Risk Factors ◽

Macular Degeneration ◽

Age Groups ◽

Significant Risk ◽

Age Related Macular Degeneration ◽

Bilateral Involvement ◽

Age Related ◽

History Of ◽

Dry Amd ◽

Wet Amd

Background The Age–related Macular Degeneration (AMD) is a common cause of visual impairment and blindness worldwide in elderly. Objective This study aimed to explore the demographic characteristics, pattern and risk factors for AMD at a tertiary referral eye centre in Nepal. Methods This is a hospital-based prospective study, conducted at Tilganga Institute of Ophthalmology, Nepal from September 2008 to May 2009. All the consecutive cases of AMD diagnosed at the institute were included. Results A total of 141 patients (266 eyes) with AMD recruited for the study. The mean age was 69.5 years (9.1SD) with three fifth males (58.9%). Housewives and occupations like agriculture comprised of 38.3% and 42.5% respectively. Three fourth (75.6%) of the patients were illiterate. The proportion of dry and wet AMD were found in 62.4% and 37.6% respectively. Bilateral involvement was seen in 88.7% of the subjects. Three fourth (71.4%) of the AMD eyes had presenting visual acuity less than 6/18. History of smoking was found in 69.9% of patients. Hypertension was the predominant systemic problem (45.4%) followed by diabetes mellitus (12.8%). Conclusion AMD is correlated with ageing in our study as well. Dry AMD is more in age groups 45-64 years and wet AMD at 65 years and older. Bilateral involvement with one eye dry and fellow eye wet AMD is more predominant (44%). Smoking and occupations like agriculture and housewife are significant risk factors for AMD. Likewise male sex, illiteracy and hypertension are other risk factors for AMD in hospital settings.DOI: http://dx.doi.org/10.3126/kumj.v9i3.6298 Kathmandu Univ Med J 2011;9(3):165-9

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Morphofunctional analysis of the macular zone after intravitreal injection of aflibercept in neovascular form age-related macular degeneration

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2020-1-204-208 ◽

2020 ◽

pp. 204-208

Author(s):

Е.V. Udovichenko ◽

◽

L.P. Emanova ◽

V.V. Egorov ◽

G.P. Smoliakova ◽

...

Keyword(s):

Macular Degeneration ◽

Intravitreal Injection ◽

Age Related Macular Degeneration ◽

Age Related ◽

Morphofunctional Analysis

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Complement factor H R1210C among Japanese patients with age-related macular degeneration

Japanese Journal of Ophthalmology ◽

10.1007/s10384-015-0394-0 ◽

2015 ◽

Vol 59 (5) ◽

pp. 273-278 ◽

Cited By ~ 3

Author(s):

Masahiro Miyake ◽

Masaaki Saito ◽

Kenji Yamashiro ◽

Tetsuju Sekiryu ◽

Nagahisa Yoshimura

Keyword(s):

Macular Degeneration ◽

Japanese Patients ◽

Factor H ◽

Age Related Macular Degeneration ◽

Complement Factor H ◽

Complement Factor ◽

Age Related

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Neovascular Macular Degeneration: A Review of Etiology, Risk Factors, and Recent Advances in Research and Therapy

International Journal of Molecular Sciences ◽

10.3390/ijms22031170 ◽

2021 ◽

Vol 22 (3) ◽

pp. 1170

Author(s):

Arunbalaji Pugazhendhi ◽

Margaret Hubbell ◽

Pooja Jairam ◽

Balamurali Ambati

Keyword(s):

Risk Factors ◽

Macular Degeneration ◽

Kinase Inhibitors ◽

Rho Kinase ◽

The Elderly ◽

Age Related Macular Degeneration ◽

Gene Therapies ◽

Rho Kinase Inhibitors ◽

Age Related ◽

Endothelial Growth Factor

Neovascular age-related macular degeneration (exudative or wet AMD) is a prevalent, progressive retinal degenerative macular disease that is characterized by neovascularization of the choroid, mainly affecting the elderly population causing gradual vision impairment. Risk factors such as age, race, genetics, iris color, smoking, drinking, BMI, and diet all play a part in nvAMD’s progression, with anti-vascular endothelial growth factor (anti-VEGF) therapy being the mainstay of treatment. Current therapeutic advancements slow the progression of the disease but do not cure or reverse its course. Newer therapies such as gene therapies, Rho-kinase inhibitors, and levodopa offer potential new targets for treatment.

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