Eyeworld

SEPTEMBER 2022 | EYEWORLD | 73 G About the physicians Malik Y. Kahook, MD Slater Family Endowed Chair in Ophthalmology University of Colorado Anschutz Medical Campus Aurora, Colorado Naresh Mandava, MD Professor and Chair Department of Ophthalmology University of Colorado Anschutz Medical Campus Aurora, Colorado Christina Y. Weng, MD, MBA Professor of Ophthalmology Cullen Eye Institute Baylor College of Medicine Houston, Texas by Ellen Stodola Editorial Co-Director I OP elevation following intravitreal injec- tions can be divided into short-term and long-term elevations, said Christina Y. Weng, MD, MBA. Short-term elevations are common, and some studies have estimated that they affect greater than 90% of patients. "Research, as well as personal experience, has shown that IOP can often elevate to the 30s or even 40s mm Hg for a transient period of time immediately following injection of anti-VEGF agents," Dr. Weng said. "However, these eleva- tions are short lasting and often resolve within 30–60 minutes, although there are some reports that IOP can remain elevated for more than a day." She added that intravitreal injections of steroid agents may be the caveat to this because in addition to the initial IOP elevation, they can sometimes lead to elevations that occur 4–6 weeks after the injection. Dr. Weng said that the data becomes "a bit more ambiguous" with long-term elevations, and there have been a number of studies with varying conclusions. "However, if you look at the largest meta-analyses and database studies, the takeaway is that persistent IOP elevation or glaucoma after repeated intravitreal injections can occur but is rare," she said. Malik Y. Kahook, MD, noted the incidence of IOP elevations is about 1–3% of patients post-anti-VEGF use. "The number is not that high, and it is still unclear to me if we see it more with one anti-VEGF agent over another," he said. "I think some of the information on IOP IOP elevation related to intravitreal injections continued on page 74 Dr. Weng administers an intravitreal injection for a patient with wet macular degeneration. Source: Christina Y. Weng, MD, MBA

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