Intra‐ocular pressure spike after Aflibercept and Ranibizumab intravitreal injections

• Published in: Acta ophthalmologica (Oxford, England) Vol. 93; no. S255
• Main Authors: El Chehab, H., Agard, E., Russo, A., Malcles, A., Dot, C.
• Format: Journal Article
• Language: English
• Published: Malden Wiley Subscription Services, Inc 01.10.2015
• Subjects: Ophthalmology
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2015.0430

Purpose Since anti‐VEGFsapproval, intra vitreous injections (IVI) represent a booming therapeutic delivery mode. Immediate ocular hypertension (OHT) induced is known after these IVIs. The purpose of this study is to compare the OHT after Aflibercept and Ranibizumab IVI. Methods In this prospective study, we compared 30 patients who received an Aflibercept IVI (0.05 mL) to 30 patients who received Ranibizumab for wet AMD. IVI were performed with a 30G needle pushed to the hilt with an anti‐reflux system. We measured intraocular pressure (IOP) using a portable aplanation tonometer PERKINS MK2 (Haag‐Streit, Koeniz, Switzerland) before injection (T0), immediately after IVI (T1), 5 minutes (T5), 15 minutes (T15) and 45 minutes (T45) after the IVI. IOP were compared by a t‐test. Results In Aflibercept group, at T0, IOP was 13.4 mmHg+1.5. All patients had a significant increase in IOP at T1 (42.7 mmHg+3, p < 0.001). At T5, IOP decreased but was still statistically higher than baseline IOP (23.6 mmHg+3.1, p < 0.001). At T15, IOP returned to normal values but was higher than T0 (16.2mmHG + 2.1, p = 0.009). At T45, IOP was 13 mmHg + 1.2, with no significant difference from baseline (p = 0.65). In Ranibizumab group, baseline IOP was 13.8 mmHg + 1.1. IOP increased at T1 (45.6 mmHg + 2.2, p < 0.001). At T5 and T15, IOP were still higher than baseline (24.6 mmHg + 2.2, p < 0.001 and 17.9 + 1.5, p < 0.001). At T45, IOP was 12.7 mmHg + 1.5, with no significant difference from baseline (p = 0.12). At each time measure, there is no statistically difference between two groups. Conclusions Aflibercept and Ranibizumab IVI induce an IOP spike for a short time. It seems to be equal between the two drugs and essentially related to the injected volume.