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.
(JAMA Ophthalmol. Published online March 16, 2017.doi:10.1001/jamaophthalmol.2017.0059; this study is available pre-embargo at the For The Media website.)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Related material: The commentary, "Anti-VEGF Injections and Glaucoma Surgery," by Michael A. Kass, M.D., of Washington University, St. Louis, and colleagues, also is available at the For The Media website.
To place an electronic embedded link to this study in your story: Link will be live at the embargo time: http://jamanetwork.