MEASUREMENT OF INTRAOCULAR PRESSURE FOLLOWING 0.05 ML (1.25MG) INTRAVITREAL INJECTION OF BEVACIZUMAB (AVASTIN) TO DETERMINE THE RATIONALE OF USING POST-INJECTION IOP LOWERING MEDICATION

Measurement of Intraocular Pressure

Abstract

Objective: To determine the change in intraocular pressure in eyes injected with 0.05 ml of intravitreal Bevacizumab (Avastin) to ascertain the need of prescribing post injection IOP lowering medications.
Type of Study: A quasi-experimental study.
Place and duration of study: Armed Forces Institute of Ophthalmology, from Jan 2010 to April 2010.
Patients and Methods: Fifty two eyes of 47 patients who were given 0.05 ml (1.25 mg) of intravitreal Avastin for retinal diseases reporting at Armed Forces Institute of Ophthalmology Rawalpindi, were included in the study. The IOP was checked prior to injection, 24 hours post injection and at 7 days on air puff computerized konometer (Topcon ct-80) to rule out operator bias and other factors like sclera rigidity. Reflux during injection was noted. All patients were given post injection antibiotic drops only. Topical steroids and topical / systemic anti glaucoma medications were not given. Patients with glaucoma and vitreous hemorrhage were excluded.
Results: Baseline mean IOP was 16.05 mm Hg, with range from 8 mm Hg to 23 mm Hg. At 24 hour post injection, 20 (38.5%) eyes showed no or ±1 mmHg change from pre injection IOP, 22 (42.3%) showed an increase of ≥2mmHg, while 10 (19.2%) eyes showed a decrease in IOP of ≤2 mmHg. On 7th day, 18 (40.0%) eyes showed either no change from pre injection reading of IOP or the change was +/- 1 mm of Hg. Fourteen patients (31.1%) had a rise of 2 mm Hg or more, 13 (25.0%) had a decrease of 2 mmHg or more as compared to pre injection reading out of which 6 (13.63%) eyes were those in which reflux had occurred.
Conclusion: Topical IOP lower agents are given routinely for 2 weeks post injection.. Our result showed significant difference in IOP 24 hour post injection but the results were not significant for 7th day. Based on our results it was suggested that long term post injection anti glaucoma agents are not required except in known cases of glaucoma.