Long-term Intraocular Pressure Changes In Patients With Neovascular Age Related Macular Degeneration Treated With Multiple Intravitreal Injections Of Ranibizumab

Adzura Salam¹, Marcel Nico Menke², Sebastian Wolf2

¹Department of Ophthalmology, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia
²Universitätsklinik fűr Augenheilkunde, Inselspital, University Bern, Bern, Switzerland

Purposed: To investigate long-term effect of intraocular pressure (IOP) in active age-related macular degeneration (AMD) patients who received multiple intravitreal injection of ranibizumab (Lucentis) (IVIL) at the different points of duration.

Methods: This retrospective study included 320 eyes of 320 patients (mean age: 79.8 ± 8.2 years) with active AMD treated with IVIL according to Bern Treatment Regime. The mean follow-up was 22.7 ± 14.1 months with range from 2 to 51 months. All patients underwent a complete ocular examination including fluorescein angiography (FA) and optical coherence tomography (OCT). The analysis included best corrected visual acuity (BCVA) at baseline and during the last visit. IOP measurement was performed at baseline prior to injection and were repeated every time prior to the next planned injection.

Results: Mean BCVA improvement was 4.51 ± 15.8 words (p<0.0001) and mean IOP increased was 0.8 ± 3.1 mmHg, (p<0.0001). Only one eye had IOP increased more than 10mmHg (11mmHg) and seven eyes had final IOP between 22 to 25 mmHg. The mean number of injections was 13.0 ± 8.0 with range from 2 to 35 injections. There was no statistically significant correlation between IOP changes and total number of injection.

Conclusions: This study demonstrated a small but significant IOP increased which was not relevant at different points of duration. Only one eye with IOP increased more than 10mmHg and no eye with final IOP more than 25mmHg. In a long run, IVIL is proven to be safe and well tolerated in subject with active AMD.