Short-term intraocular pressure changes after Aflibercept (Eylea©) intravitreal injections: which factors should be considered?

Abstract

Abstract Purpose: To measure and interpret short-term pressure variation after intravitreal injections of the anti-vascular endothelial growth factor drug aflibercept (Eylea©), and to identify variables and risk factors for increased pressure spikes. Methods and materials: A prospective study was conducted on 103 eyes treated with intravitreal aflibercept (Eylea©). IOP was measured using the Icare® TA01i tonometer immediately before, and 1, 5, and 20 minutes after the procedure. Patient data were reviewed according to age, gender, diagnostic, phakic status, and glaucoma history. Results: Mean values of IOP before, and 1, 5 and 20 minutes after the injection were 14,89 (± 4,19) mmHg, 36,77 (± 11,46) mmHg, 24,17 (± 7,81) mmHg and 16,54 (± 5,26) mmHg, respectively. Significant differences were found in patients with a history of glaucoma, 20 minutes after the injection. No significant differences were found between phakic and pseudophakic patients. Conclusions: More than three-quarters (76,7%) of the patients had an IOP higher than 30 mmHg 1 minute after the injection. Almost half (47,57%) had an IOP higher than 40 mmHg. Phakic status didn’t seem to affect IOP after intravitreal injections. Patients with a history of glaucoma may have a slower postinjection IOP decrease, shown by a mean IOP difference of 3,72 mmHg, 20 minutes after the injections. These patients are at a greater risk for progressive worsening of their glaucoma due to repeated IOP spikes after multiple IVI. IOP should be closely monitored, and a low threshold for optimizing topical therapy should be established.