First Author: F.Ulaş TURKEY
Co Author(s): E. Uyar S. Sahin S. Celebi
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To evaluate effect of vitreous reflux on short-term intraocular pressure (IOP) changes measured using Tonopen after the intravitreal injection of ranibizumab.
Ophthalmology Deparment, Abant Izzet Baysal University, Faculty of Medicine Hospital.
Age-related macular degenation, diabetic maculopathy and retinal vein occlusion patients who underwent intravitreal injection of 0.05ml ranibizumab comprised the study population. Overall, 316 eyes of 276 patients were injected and vitreous reflux volume of the patients were recorded and patients were divided into 3 groups according to volume of vitreous reflux. Group 1 included patients with no detectable reflux, Group 2 included patients having conjunctival bleb with less than 3mm diameter and Group 3 included patients having conjunctival bleb with more than 3mm diameter. IOP measurements were performed before the injection, immediately after the injection and 30 min after the injection using Tonopen-Avia. Statistical analysis of data was performed using one-way analysis of variance test.
Sixty-eight eyes (21.52%) were in Group 1, 108 eyes (34.18%) in Group 2 and 140 eyes (44.30%) were in Group 3. IOP of the groups measured before the injection were not significantly different (p=0.901). But IOP of the groups measured immediately after the injection and 30 min after the injection were significantly different (p<0.001). The mean IOP of the groups measured immediately after the injection were 44.35±12.07, 34.66±13.17 and 17.65±8.56 mmHg, respectively. The mean IOP of the groups measured 30 min after the injection were 18.67±6.34, 17.39±5.53 and 14.99±4.40 mmHg, respectively. Post-hoc analysis using Tukey test revealed there was significant difference between the all groups for immediate IOP measurements (p<0.001), there was no difference between group 1 and group 2 for 30 min IOP measurements (p=0.261) but there was significant difference between group 3 and other groups (p values were <0.001 and 0.001, respectively) .
IOP may remarkably increase immediately after the intravitreal injection of ranibizumab especially in the absence of vitreous reflux. Volume of vitreous reflux may affect postinjection IOP changes. However, in most of the patients IOP decreased in 30 min without any intervention.