scholarly journals Long – Term Intraocular Pressure Changes after Intravitreal Injections

2017 ◽  
Vol 17 (2) ◽  
pp. 14-16
Author(s):  
Sintija Grava ◽  
Guna Laganovska
Keyword(s):  
Intraocular Pressure ◽  
Macular Degeneration ◽  
Measuring Method ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
University Hospital ◽  
Glaucoma Diagnosis ◽  
Age Related ◽  
Number Of Patients ◽  
The Right

Abstract Introduction. Direct drug delivery by intravitreal injection is an essential tool in the treatment of retinal diseases and the studies have demonstrated that patients undergoing treatment with intravitreal anti-VEGF agents may experience sustained and delayed elevation of intraocular pressure. According to literature, the incidence of sustained elevation of intraocular pressure varied from 3.45% - 11.6%. Aim of the Study.To research the changes of intraocular pressure after intravitreal injections in patients with a diagnosis of agerelated macular degeneration, diabetic maculopathy, and retinal vein occlusions. Material and Methods. A prospective study was done in Pauls Stradins Clinical University Hospital, Riga, Latvia from November 2015 - January 2016. In this study were interviewed and examined 31 patients who had had intravitreal injections. For data analysis, SPSS 23 was used. Results. From 31 patient there were 20 (65.5%) females and 11 (35.5%) males. They were divided into three groups depending on the diagnosis. There were 26 (83.9%) patients with age-related macular degeneration, 3 (9.7%) with diabetic retinopathy and 2 (6.5%) with retinal vein thrombosis. From 31 patient the IOP after intravitreal injections were increased in 21 (67.7%) patient - 13 (41.9%) in the right eye and 10 (32.2%) in the left eye. In both eyes the pressure was increased from 14 to 17 mmHg (14.08 to 17.08 mmHg in the right eye and 14.1 to 17.3 in the left eye). From 6 (19.3%) patients who had glaucoma before intravitreal injections, in 4 (66%) intraocular pressure had increased from 14.7 to 18.5 mmHg in the right eye and from 12.5 to 17 mmHg in the left eye. Conclusions. Patients with previously diagnosed glaucoma had a greater rise in intraocular pressure compared to patients with no glaucoma diagnosis. Further studies with a greater number of patients and identical intraocular pressure measuring method before and after injections are needed to better evaluate the effects of intravitreal injections on intraocular pressure.

scholarly journals A Case of Sustained Intraocular Pressure Elevation after Multiple Intravitreal Injection of Ranibizumab and Aflibercept for Neovascular Age-Related Macular Degeneration

2016 ◽  
Vol 7 (1) ◽  
pp. 230-236 ◽  
Author(s):  
Hisashi Matsubara ◽  
Ryohei Miyata ◽  
Maki Kobayashi ◽  
Hideyuki Tsukitome ◽  
Kengo Ikesugi ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Macular Degeneration ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Multiple Injections ◽  
Anti Vegf ◽  
Age Related ◽  
Intravitreal Aflibercept ◽  
Iop Elevation

Intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents are widely used to treat neovascular age-related macular degeneration (nAMD). Although these treatments are effective, multiple injections have recently been recommended to ensure that there is a good long-term prognosis. However, sustained intraocular pressure (IOP) elevations have been reported to develop after multiple injections of anti-VEGF agents. We present our findings of a case of uncontrolled and persistent IOP elevation after switching from intravitreal ranibizumab injections to intravitreal aflibercept injections. A 74-year-old Japanese man without a history of glaucoma underwent 22 ranibizumab injections for nAMD and suddenly developed an elevated IOP after the 22nd injection. Although the subsequent medical treatment led to normalization of his IOP, the subretinal fluid under the central fovea remained even after the 25th injection of ranibizumab. Thus, ranibizumab treatment was switched to bimonthly intravitreal aflibercept injections in conjunction with glaucoma medications. His IOP recovered to within the normal range; however, after the 11th aflibercept injection, there was a sudden elevation of his IOP in spite of the continued glaucoma medications. Due to this sustained IOP elevation, his aflibercept injections were suspended for 16 weeks. Because his IOP could not be normalized by a full glaucoma medication regimen, the patient underwent trabeculotomy, which resulted in a lowering of the IOP to normal levels. We conclude that patients who receive serial intravitreal injections of anti-VEGF agents need to be closely monitored because severe and sustained ocular hypertension can develop.

scholarly journals Questionnaire Survey on Driving among Patients with Age-Related Macular Degeneration in Japan

2021 ◽  
Vol 10 (21) ◽  
pp. 4845
Author(s):  
Chikako Hara ◽  
Miki Sawa ◽  
Fumi Gomi ◽  
Kohji Nishida
Keyword(s):  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
University Hospital ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Paracentral Scotoma ◽  
The Mean ◽  
The Right ◽  
The Relationship ◽  
Car Driving

Purpose: This study aimed to assess driving capabilities in patients with exudative age-related macular degeneration (AMD) causing unilateral blindness or paracentral scotoma without vision deterioration. Methods: Of the 275 patients with AMD who responded to a questionnaire regarding car driving at Osaka University Hospital, we excluded 78 patients who answered that they had never driven. Finally, 197 patients were included (50 with bilateral and 142 with unilateral AMD). We investigated the relationship between the questionnaire findings and best-corrected visual acuity (BCVA). Results: The mean age was 74.8 ± 6.9 years, and the mean BCVA in the right and left eyes were 0.48 and 0.47, respectively. A negative correlation was observed between the proportion of patients who stopped driving due to AMD and the vision in the worse eye (p < 0.0001); however, 66% of participants were still driving. Regardless of the BCVA, 84% of them wished to continue driving. Concerning perceived dangerous situations, all patients reported an oversight of people or signals and night driving; further, patients with unilateral and bilateral vision deterioration reported vision narrowness and difficulty with discerning signal colours, respectively. Conclusion: Despite the associated danger, patients with AMD continued driving. Close attention should be paid to the driving activities among patients with AMD, even if they have passed the relevant driving tests.

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

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maiko Maruyama-Inoue ◽  
Tatsuya Inoue ◽  
Shaheeda Mohamed ◽  
Yoko Kitajima ◽  
Shoko Ikeda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intraocular Pressure ◽  
Macular Degeneration ◽  
Intravitreal Injection ◽  
Odds Ratio ◽  
Japanese Patients ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Elevated Intraocular Pressure ◽  
History Of

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.

scholarly journals Efficacy of Psychiatric Treatment to Treat a Specific Phobia of Intravitreal Injections in a Patient with Neovascular Age-Related Macular Degeneration

2021 ◽  
pp. 48-56
Author(s):  
Atsuta Ozaki ◽  
Hisashi Matsubara ◽  
Masahiko Sugimoto ◽  
Manami Kuze ◽  
Mineo Kondo ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Macular Edema ◽  
Psychiatric Treatment ◽  
Early Stage ◽  
Behavioral Therapy ◽  
Specific Phobia ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Anti Vegf ◽  
Age Related

Intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) is essential for the treatment of macular diseases such as wet age-related macular degeneration and macular edema. Although continued treatment is needed to maintain good vision, some patients cannot continue such injections for various reasons, including specific phobias. Here, we report a case of a patient with a specific phobia of intravitreal injections who could resume treatment after undergoing combined drug and cognitive-behavioral therapy (CBT). A 74-year-old Japanese man diagnosed with retinal angiomatous proliferation by fluorescein angiography and indocyanine green angiography was treated with intravitreal anti-VEGF injection. However, at 8 months after the first treatment, he became difficult to treat because of a phobia of injections. He was treated with photodynamic therapy, but his macular edema did not improve. After a psychiatric consultation, he was diagnosed with a specific phobia of intravitreal injections. Combined drug and CBT enabled him to resume receiving intravitreal injections. This case demonstrates that a specific phobia of intravitreal injections may benefit from combined drug and CBT. In this regard, some patients with high anxiety and fear of intravitreal injections should be referred to a psychiatrist at an early stage.

Sign in / Sign up

Export Citation Format

Share Document