To monitor mean changes in intraocular pressure following intravitreal injection of bevacizumab in exudative age related macular degeneration and proliferative diabetic retinopathy

Abstract

Objective: To monitor the effect of Intravitreal injection of bevacizumab on intraocular pressure in order to know whether intraocular pressure lowering medication or paracentesis is required prophylactically or thereafter.

Subjects and methods: A prospective intervensional case series of 90 eyes with proliferative diabetic retinopathy and exudative Age related macular degeneration was done who received intravitreal injection of bevacizumab. Intraocular pressure was recorded with Goldman applantaion tonometer at baseline, and then after procedure at 5min, 30 min, 01 hours and 01 weeks. The pateints data was recorded of age, gender, disease, intraocular pressure, history of glaucoma, previous surgery, phakic status and topical and systemic medications.

Results: The mean baseline intraocular pressure was found to be 13.54±2.1 in Proliferative diabetic retinopathy and 12.76±1.8 in Exudative Age related macular degeneration (p-value 0.046). The mean intraocular pressure elevation following Intravitreal bevacizumab at 5min was 32.89±6.3 in proliferative diabetic retinopathy and in exudative Age related macular degeneration was 32.18±5.7 (p-value 0.510), at 30 min was 16.71±2.6 and 15.53±2.4 (p-value <0.024), at one hour was 14.20±2.0 and 13.47±1.9 (p-value 0.095) and at one week 13.82±1.7 and 13.06±1.7 (p-value 0.126) in proliferative diabetic retinopathy and exudative Age related macular degeneration respectively. So there was no significant difference between the two diseases.

Conclusion: There is abrupt and transient rise in the intraocular pressure following intravitreal injection of bevacizumab, but it did not remain elevated for longer duration hence there was no need of intraocular pressure lowering medication and paracentesis.