Ocular hypertension after intravitreal injections

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Intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF) for the treatment of age-related macular degeneration with choroidal neovascularization have become much more popular nowadays. Anti-VEGF therapy is generally well-tolerated; however, one of its possible side effects is ocular hypertension — elevation of intraocular pressure (IOP) above the accepted norm, but without structural and functional changes in the retina and optic nerve common for glaucoma. The average duration of IOP elevation is 30 to 60 minutes, but it can increase when the patient has primary open-angle glaucoma (POAG). There is currently no uniform understanding of the pathogenesis of elevated IOP after IVI, as well as the effect of IOP fluctuations on the functional prognosis and the condition of the ocular tunics. This review considers the main causes and mechanisms of IOP elevation after IVI, analyzes recent publications on the consequences of ocular hypertension for the neurosensory part of the retina and the optic nerve, and examines the conditions for transition of IOP fluctuations into clinically significant ocular hypertension or POAG.

Keywords:

anti-VEGF drugs

intravitreal injection

intraocular pressure

primary open-angle glaucoma

Authors:

Erichev V.P.

Krasnov Research Institute of Eye Diseases

ORCID: 0000-0001-6842-7164

Tarasenkov A.O.

Research Institute of Eye Diseases

Andreeva Yu.S.

Research Institute of Eye Diseases

Received:

17.06.2021

Accepted:

24.02.2022

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