İntravitreal Anti-VEGF enjeksiyonu sonrası göz içi basınç ve oküler aksiyel uzunluk değişiklikleri

Yıl 2013, Cilt: 4 Sayı: 3, 326 - 330, 01.09.2013

Hasan Ali Tufan Selçuk Kara Sedat Arıkan Baran Gencer Metin Ünlü

https://doi.org/10.5799/jcei.122264

Öz

Amaç: İntravitreal anti-vasküler endotelyal growth faktör (anti-VEGF) enjeksiyonu sonrası göziçi basıncı (GİB) ve oküler aksiyel uzunluk (AU) değişikliklerinin değerlendirilmesi. Yöntemler: Kliniğimizde intravitreal bevacizumab veya ranibizumab enjeksiyonu uygulanan hastalar prospektif olarak değerlendirildi. GİB, Tono-Pen kullanılarak ve oküler AU, ultrason biyometri kullanılarak, enjeksiyondan önce (GİB0, AU0), enjeksiyondan 1 dakika (GİB1, AU1) ve 24 saat (GİB2, AU2) sonra ölçüldü. Artmış GİB ve AU ile ilişkili faktörler lojistik regresyon analizi kullanılarak incelendi. Bulgular: Ortalama yaş 66,7±12 olup 53\'ü (%55) erkek ve 43\'ü (%45) kadın olmak üzere toplam 96 hasta değerlendirildi. GİB0\'ın 15,2±3,5 mmHg\'dan, 22,2±8,6 mmHg\'ya (GİB1) yükseldiği görülmüştür (p

Anahtar Kelimeler

İntravitreal enjeksiyon, intraoküler basınç, oküler aksiyel uzunluk.

Alterations in intraocular pressure and ocular axial length after intravitreal Anti-VEGF injection

Öz

Objective: To evaluate the effect of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection on intraocular pressure (IOP) and ocular axial length (AL). Methods: A prospective series of consecutive patients undergoing injection of intravitreal bevacizumab or ranibizumab in our clinic was investigated. IOP was measured with Tono-Pen and ocular AL with ultrasound biometry before (IOP0, AL0) and about 1 min (IOP1, AL1) and 24 hours (IOP2, AL2) after intravitreal injection. Logistic regression analysis was used to investigate factors (lens status, presence of glaucoma and previous intravitreal injection) associated with increased IOP and AL. Results: We recruited 96 patients with a mean age of 66.7±12 years, 53 (55%) men and 43 (45%) women. One minute after the injection (IOP1), mean IOP increased from 15.2±3.5 mmHg (IOP0) to 22.2±8.6 mmHg (p

Anahtar Kelimeler

Intravitreal injection, intraocular pressure, ocular axial length.

Kaynakça

• Brand CS. Management of retinal vascular diseases: a patient-centric approach. Eye (Lond) 2012;26:1-16.
• Alakuş MF, Taş M, Öner V, et al. Diabetik Maküla Öde- minde İntravitreal Bevacizumab Etkinliğininin Değer- lendirilmesi. Retina Vitreus 2012;1:35-40.
• Tolentino M. Systemic and ocular safety of intravitreal anti-VEGF therapies for ocular neovascular disease. Surv Ophthalmol 2011;56:95-113.
• Wong LJ, Desai RU, Jain A, et al. Surveillance for potential adverse events associated with the use of intravitreal bevacizumab for retinal and choroidal vas- cular disease. Retina 2008;28:1151-1158.
• Bakri SJ, Pulido JS, McCannel CA, Hodge DO, Diehl N, Hillemeier J. Immediate intraocular pressure chang- es following intravitreal injections of triamcinolone, pegaptanib, and bevacizumab. Eye 2009;23:181-185.
• Sharei V, Höhn F, Köhler T, et al. Course of intraocular pressure after intravitreal injection of 0.05 mL ranibi- zumab (Lucentis). Eur J Ophthalmol 2010;20:174- 179.
• Kotliar K, Maier M, Bauer S, et al. Effect of intravitreal injections and volume changes on intraocular pres- sure: clinical results and biomechanical model. Acta Ophthalmol Scand 2007;85:777-781.
• Gismondi M, Salati C, Salvetat ML, et al. Short term effect of intravitreal injection of Ranibizumab (Lucen- tis) on intraocular pressure. J Glaucoma 2009;18:658- 661.
• Höhn F, Mirshahi A. Impact of injection techniques on intraocular pressure (IOP) increase after intravitreal ranibizumab application. Graefes Arch Clin Exp Oph- thalmol 2010;248:1371-1375.
• Goktas A, Goktas S, Atas M, et al. Short-term impact of intravitreal ranibizumab injection on axial ocular di- mension and intraocular pressure. Cutan Ocul Toxicol 2013;32:23-26.
• Cacciamani A, Oddone F, Parravano M, et al. Intravit- real injection of bevacizumab: changes in intraocular pressure related to ocular axial length. Jpn J Ophthal- mol 2013;57:63-67.
• Meyer CH, Holz FG. Preclinical aspects of anti-VEGF agents for the treatment of wet AMD: ranibizumab and bevacizumab. Eye (Lond) 2011;25:661-672.
• Shingleton BJ, Gamell LS, O’Donoghue MW, et al. Longterm changes in intraocular pressure after clear corneal phacoemulsification: normal patients versus glaucoma suspect and glaucoma patients. J Cataract Refract Surg 1999;25:885-890.
• Shingleton BJ, Pasternack JJ, Hung JW, O’Donoghue MW. Three- and five year changes in intraocular pres- sures after clear corneal phacoemulsification in open angle glaucoma patients, glaucoma suspects, and normal patients. J Glaucoma 2006;15:494-498.
• Poley BJ, Lindstrom RL, Samuelson TW. Long term effects of phacoemulsification with intraocular lens implantation in normotensive and ocular hypertensive eyes. J Cataract Refract Surg 2008;34:735-742.
• Hayashi K, Hayashi H, Nakao F, Hayashi F. Changes in anterior chamber angle width and depth after intra- ocular lens implantation in eyes with glaucoma. Oph- thalmology 2000;107:698-703.
• Meyer MA, Savitt ML, Kopitas E. The effect of phaco- emulsification on aqueous outflow facility. Ophthal- mology 1997;104:1221-1227.
• Kerimoglu H, Ozturk BT, Bozkurt B, et al. Does lens status affect the course of early intraocular pressure and anterior chamber changes after intravitreal injec- tion? Acta Ophthalmol 2011;89:138-142.
• Hollands H, Wong J, Bruen R, et al. Short-term in- traocular pressure changes after intravitreal injection of bevacizumab. Can J Ophthalmol 2007;42:807-811.
• Leydolt C, Findl O, Drexler W. Effects of change in intraocular pressure on axial eye length and lens posi- tion. Eye (Lond) 2008;22:657-661.
• Read SA, Collins MJ, Annis-Brown T, et al. The short- term influence of elevated intraocular pressure on ax- ial length. Ophthalmic Physiol Opt 2011;31:398-403.