Patients with age-related macular degeneration who received seven or more eye injections of the drug bevacizumab annually had a higher risk of having glaucoma surgery, according to a study published online by JAMA Ophthalmology.
The advent of intravitreous (in the vitreous, the fluid behind the lens in the eye) anti-vascular endothelial growth factor (VEGF) injections to treat common causes of vision loss, such as exudative (wet) age-related macular degeneration (AMD) and diabetic macular edema has improved visual outcomes for many patients. Intravitreous injections of anti-VEGF agents may increase the risk of elevated intraocular pressure (IOP); however, the risk of developing moderate to advanced glaucoma requiring glaucoma surgery has been unclear.
Brennan D. Eadie, M.D., Ph.D., of the University of British Columbia, Vancouver, and colleagues conducted a study that included patients who had received intravitreous bevacizumab injections for exudative age-related macular degeneration. Cases were identified using glaucoma surgical codes for various procedures. For each case, 10 controls were identified; the number of intravitreous bevacizumab injections received per year was determined for both cases and controls.
Seventy-four cases of glaucoma surgery and 740 controls were identified. The researchers found that seven or more injections were associated with a significantly higher risk of glaucoma surgery.
"Clinicians should be aware of the potential association of repeated, recent intravitreous anti-VEGF injections for diseases, such as exudative AMD, with subsequent need for glaucoma surgery," the authors write.
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JAMA Ophthalmol. Published online March 16, 2017.DOI: 10.1001/jamaophthalmol.2017.0059