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Beitragstitel Short-term intraocular pressure changes after aflibercept 2 mg versus aflibercept 8 mg intravitreal injections: a comparative, prospective real-world study
Beitragscode P35
Autor:innen
  1. Arianna Paris EOC Ospedale Regionale di Lugano - Italiano Präsentierende:r
  2. Gabriela Grimaldi EOC Ospedale Regionale di Lugano - Italiano
  3. Moreno Menghini EOC Ospedale Regionale di Lugano - Italiano
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Abstract-Text Purpose:Intraocular pressure (IOP) elevation following intravitreal injections (IVT) may promote glaucomatous damage; with the increase in volume related to Aflibercept 8 mg (0.07 ml versus 0.05 ml in Aflibercept 2 mg), this risk could be higher. This study aims to observe and compare short-term IOP fluctuations after IVT of Aflibercept 2 mg and Aflibercept 8 mg.
Methods: Patients were divided into 2 groups: aflibercept 2 mg (Group 1) and aflibercept 8 mg (Group 2). IOP measurements were performed with a rebound tonometer before the procedure and at 3 time points: 30 seconds, 5 minutes, and 15 minutes after IVT. Patients with a history of glaucoma or ocular hypertension were excluded. Primary outcome measure was the change in IOP pre and post injection. Secondary outcome measure was the incidence of acute IOP elevation leading to short-term transient visual loss requiring a paracentesis. A larger sample is expected as further data will be collected over the following 6-months.
Results: A preliminary sample of 22 eyes of 22 patients with a mean age of 76.9 ± 12.3 years was included; 10 eyes received Aflibercept 2 mg, whereas 12 eyes received Aflibercept 8 mg. The IOP peaked acutely after IVT in both groups, with a mean IOP of 43.8 mmHg and 50.5 mmHg in groups 1 and 2, respectively, at 30 seconds. An IOP rise above 50 mmHg at 30 seconds was observed in 30% of patients of Group 1, and in 60% of patients in Group 2. In all cases with IOP increase, the pressure normalized to almost pre-operative values at the 15-minutes measurement, with a mean IOP after 15 minutes of 17.4 mmHg in Group 1 and 19.9 mmHg in Group 2 (p=0.198). Ninety % of patients in Group 1 and 75% of patients in Group 2 reached an IOP level lower than 25 mmHg after 15 minutes (p=0.594). Transient visual loss requiring a paracentesis was not observed in any patient.
Conclusion: It is known from previous clinical studies that IOP spikes are commonly observed after IVT at dose of 0.05 ml, but few reports are available about post-injection IOP variations at the dose of 0.07 ml. Our preliminary data suggest that Aflibercept 8 mg might lead to a relatively higher IOP elevation immediately after the procedure compared to Aflibercept 2 mg. Nevertheless, the IOP returned to a value lower than 25 mmHg after 15 minutes in most patients from both groups. Further longitudinal studies are warranted to better assess the long-term impact of short-term IOP fluctuations on anatomical and functional parameters