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Klin Monbl Augenheilkd 2018; 235(11): 1278-1284
DOI: 10.1055/s-0043-118851
Klinische Studie
Georg Thieme Verlag KG Stuttgart · New York

Der Einfluss multipler Anti-VEGF-Injektionen auf den intraokularen Druck

The Impact of Multiple Intravitreal Anti-VEGF Injections on Intraocular Pressure
Ioannis Lamprakis
1   Augenklinik, Universitätsspital Basel, Schweiz
,
Margarita Georgieva Todorova
1   Augenklinik, Universitätsspital Basel, Schweiz
,
Matthias Grüb
2   Augenheilkunde, Villa im Lindengarten, Breisach am Rhein
,
Torsten Schlote
3   Augenheilkunde, Tagesklinik Ambimed, Basel, Schweiz
› Author Affiliations
Further Information

Publication History

eingereicht 27 June 2017

akzeptiert 20 August 2017

Publication Date:
25 October 2017 (online)

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Zusammenfassung

Hintergrund Multiple Anti-VEGF-Injektionen sollen als möglicher Risikofaktor für postoperative Augendruckerhöhungen untersucht werden.

Methode Es wurden 50 Augen von 50 Patienten in die retrospektive Studie aufgenommen, die mindestens 10 intravitreale Injektionen mit VEGF-Inhibitoren (Indikationen: altersbedingte Makuladegeneration, diabetische Makulopathie, Makulaödem nach retinalem Venenverschluss) an einem Auge erhalten hatten und deren Augendruck am 1. postoperativen Tag gemessen wurde. Ein Intraokulardruck (IOD) > 21 mmHg wurde als erhöht eingestuft und auf einen Zusammenhang zur Zahl der Injektionen hin untersucht.

Ergebnisse Es wurden 669 IOD-Messungen analysiert (nach im Mittel 13,4 Injektionen pro Auge). Bei 43 Augen (86%) kam es nach keiner Injektion zu einer IOD-Erhöhung am 1. postoperativen Tag. Eine transiente IOD-Erhöhung (> 21 mmHg) war nach 19 Injektionen (2,8%) zu verzeichnen (1 Patient davon mit 8 IOD-Erhöhungen). Es konnte keine persistierende IOD-Erhöhung oder Tendenz zur Zunahme von transienten IOD-Erhöhungen mit zunehmender Zahl der Injektionen nachgewiesen werden. Augen mit bekanntem Glaukom waren signifikant häufiger von einer IOD-Erhöhung betroffen als Augen ohne Glaukom (5,5 vs. 2,2%).

Schlussfolgerungen Multiple intravitreale Injektionen von Anti-VEGF-Inhibitoren sind kein eigenständiger Risikofaktor für persistierende Augendruckerhöhungen. Individuelle Risikofaktoren (z. B. präexistentes Glaukom) prädisponieren jedoch zu transienten IOD-Erhöhungen.

Abstract

Background To evaluate the possible effects of multiple intravitreal anti-vascular endothelial growth factor (VEGF) injections on intraocular pressure (IOP).

Methods This study included 50 eyes of 50 patients who underwent multiple (≥ 10 injections) intravitreal anti-VEGF injections in one eye with age-related macular degeneration, diabetic macular edema or retinal vein occlusion. IOP was recorded after every injection on the first postoperative day. IOP > 21 mmHg was regarded as abnormal. For statistical analysis, the IOP was correlated with the number of injections.

Results A total of 669 IOP-measurements (mean 13.4 treatment/eye) were analyzed. No IOP-elevation was recorded in 43 eyes (86%). Transient elevated IOP > 21 mmHg was measured after 19 intravitreal injections (2.8%, one patients with 8 IOP elevations). In general, there was no increasing risk of IOP elevation with time, no case of sustained IOP elevation and no additional long term glaucoma treatment necessary. Eyes with pre-existing glaucoma were significantly more affected from transient IOP-elevation than non-glaucoma eyes (5.5 vs. 2.2%).

Conclusions Multiple anti-VEGF injections are not associated with an increased risk of sustained IOP-elevation. On the other hand, individual risk factors exist and predispose to IOP-elevation (e.g., pre-existing glaucoma).

Schlüsselwörter

altersbedingte Makuladegeneration - Glaukom - retinaler Venenverschluss - intraokularer Druck - intravitreale Injektionen

Key words

age-related macular degeneration - glaucoma - retinal vein occlusion - intraocular pressure - intravitreal injections - VEGF inhibitors
 

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