Intraocular Pressure Changes After Intravitreal Injection of Bevacizumab In Patients With Diabetic Macular Edema

Arfa Shaikh, Zeeshan Kamil, Afshan Ali, Irfan Shafiq, Saeed Iqbal, Saliha Naz

Abstract

Objective

To find out the change in the mean intraocular pressure at various time intervals after intravitreal injection of bevacizumabÊin patients with diabetic macular edema.

Study design

Prospective cohort study.

Place & Duration of study

The Layton Rahmatulla Benevolent Trust (LRBT) Tertiary Teaching Eye Hospital Korangi Karachi, from March 2023 to August 2023

Methods

Intravitreal injection of bevacizumab (1.25mg) was administered via the pars plana region, 3.5-4.0 mm from the inferotemporal limbus. Intraocular pressure (IOP) was assessed immediately after injection. Patients were followed on day-1, one-week, and after one-month. The repeated measures of ANOVA test was used to compare the mean changes in IOP. A p value of <0.05 was taken as significant. Independent (student) t-test was applied for comparison of continuous variables (e.g., IOP, RNFL thickness, macular thickness) between two independent groups such as gender, age groups, and presence or absence of side effects.

Results

A total of 150 patients with 82 (54.7%) males and 68 (45.3%) females were enrolled. Seventy-eight (52%) patients were =45-years of age. Fourteen (9.3%) individuals exhibited a very mild condition, whereas 69 (46%) presented with a light condition. Moderate and severe condition were noted in 21 (14%) participants each, whereas 25 (16.7%) patients had a very severe condition. Adverse effects were reported by 49 (32.7%) patients.

Immediately following the bevacizumab injection, the IOP was 24.23±3.98 mmHg. After 1-day, IOP was 20.67±4.03 mmHg, indicating a considerable reduction from immediate post-injection level. After one-week, IOP was 16.99±3.39 mmHg, and 16.44±3.37 mmHg after one-month.

Conclusion

The administration of intravitreal bevacizumab resulted in a temporary increase in intraocular pressure, that subsided within a day and then continued to decline over a period of one-month.

Key words

Intraocular Pressure, Intravitreal injection, Bevacizumab, Diabetic macular edema, Vascular endothelial growth factor.