4.4 Review

The link between intravitreal antivascular endothelial growth factor injections and glaucoma

Journal

CURRENT OPINION IN OPHTHALMOLOGY
Volume 25, Issue 2, Pages 127-133

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ICU.0000000000000036

Keywords

antivascular endothelial growth factor; glaucoma; intraocular pressure

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Funding

  1. Genentech
  2. Regeneron

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Purpose of reviewTo summarize the reports of both transient and sustained elevation in intraocular pressure (IOP) associated with intravitreal injections of antivascular endothelial growth factor (anti-VEGF) agents and to review the possible mechanisms for these findings.Recent findingsTransient elevation in IOP is common after intravitreal injection of anti-VEGF agents. Sustained IOP elevation is less commonly seen but can require medical and/or surgical intervention. The mechanism for sustained IOP elevation is not well understood but has been attributed to trabecular meshwork injury from repeated injections, a potential toxic or inflammatory reaction after exposure to the biologic agents and/or vehicle, or mechanical blockade of the trabecular meshwork by protein aggregates or contaminant particles associated with packaging and injection techniques, among other potential causes.SummaryIntravitreal anti-VEGF injections are commonly used to treat neovascular diseases of the eye. Although they have a favorable side-effect profile, their use can be associated with both transient and sustained elevation in IOP. Further research is necessary to determine the cause of these findings.

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