First Author: N.I.Ucgun TURKEY
Co Author(s): Y. Atalay Z. Yazar M. Onen H. Sarikatipoglu 0 0 0 0 0 0 0 0 0
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The purpose of this study is to evaluate the short term intraocular pressure(IOP) changes after intravitreal ranibizumab injections for diabetic macular edema and to determine the efficacy of prophylactic anti-glaucomatous treatment.
Ankara Numune Education and Research Hospital, Turkey
A total of 32 patients’ 44 eyes that received intravitreal injections of ranibizumab(0.1 ml) for diabetic macular edema were enrolled prospectively. Patients were divided into two groups. In the first group, the mean age was 65.3(44-87) and %55.5 of patients were woman, %44.5 of patients were man. The average number of injections were 1.72. In the second group, the mean age was 62.5(49-76) and %35.8 of patients were woman, %64.2 of patients were man. The average number of injections were 1.16. While the first group (18 patients 25 eyes) didn’t receive any medication, the second group(14 patients 19 eyes) was applied topical brimonidine %0.15, 2 hours before the intravitreal injection. IOP values at baseline, 1 hour and 24 hours after the injection were measured using non-contact pneumotometry. Injections were repeated at the end of the month and IOP measurements were recorded.
In the first group, the mean IOP value was 16mmHg. Mean IOP value was 24.7mmHg 1 hour after the injection and 18.7 mm Hg after 24 hours. Mean IOP value after the first day of injection was markedly higher than pre-injection levels and the difference was statistically significant(p< 0.05). One hour after the injection, IOP levels higher than 40 mmHg were evaluated as acute IOP elevation and two patients were treated with acetozolamide in this group. One patient was diagnosed glaucoma and topical brimonidine treatment was initiated. İnjections were repeated at the end of the month and after 1 hour, the mean IOP value was 22.4mmHg. 24 hours after the injection IOP lowered to 16.6mmHg. In the second group the mean IOP value was 14mmHg. Mean IOP value was 16.8 mm Hg 1 hour after the injection and 14.8mmHg after 24 hours. 1 hour after the injection IOP measurements were similar to pre-injection levels. There were no acute IOP elevation in this group. Comparing two groups 1 and 24 hours after the injection, IOP levels were significantly higher in the first group that didn’t receive any medication(p< 0.05).
After intravitreal injections, IOP elevation isn’t an unusual condition especially in short terms. 1 hour after the injection, IOP value is significantly lower in eyes treated prophylactically. IOP is also stabile 24 hours after the injection comparing to the group that didn’t receive any medication. Topical brimonidine treatment appears to be a safe option for the patients that will receive intravitreal ranibizumab injection.