Incidence of Glaucoma or Ocular Hypertension After Repeated Anti-Vascular Endothelial Growth Factor Injections for Macular Degeneration

Jeremy B Wingard,1 Darcie AP Delzell,2 Nathan V Houlihan,2 Jonathan Lin,2 Jon P Gieser1 1Wheaton Eye Clinic, Wheaton, IL 60187, USA; 2Mathematics and Computer Science Department, Wheaton College, Wheaton, IL, 60187, USACorrespondence: Jeremy B WingardWheaton Eye Clinic, 2015 N. Main Street, Wheaton,...

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Autores principales:	Wingard JB, Delzell DAP, Houlihan NV, Lin J, Gieser JP
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	exudative macular degeneration secondary glaucoma open-angle glaucoma anti-vascular endothelial growth factor Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/bd57ea1c0f8344c38c7dfa48bd94ad6c
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spelling	oai:doaj.org-article:bd57ea1c0f8344c38c7dfa48bd94ad6c2021-12-02T06:02:57ZIncidence of Glaucoma or Ocular Hypertension After Repeated Anti-Vascular Endothelial Growth Factor Injections for Macular Degeneration1177-5483https://doaj.org/article/bd57ea1c0f8344c38c7dfa48bd94ad6c2019-12-01T00:00:00Zhttps://www.dovepress.com/incidence-of-glaucoma-or-ocular-hypertension-after-repeated-anti-vascu-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Jeremy B Wingard,1 Darcie AP Delzell,2 Nathan V Houlihan,2 Jonathan Lin,2 Jon P Gieser1 1Wheaton Eye Clinic, Wheaton, IL 60187, USA; 2Mathematics and Computer Science Department, Wheaton College, Wheaton, IL, 60187, USACorrespondence: Jeremy B WingardWheaton Eye Clinic, 2015 N. Main Street, Wheaton, IL 60187, USATel +1 630-668-8250Email jbwingard@gmail.comPurpose: To estimate the risk of glaucoma or sustained ocular hypertension (OHT) related to anti-vascular endothelial growth factor (VEGF) injections for age-related macular degeneration (AMD).Design: Retrospective chart review.Subjects: Patients who received unilateral anti-VEGF injections for AMD at the Wheaton Eye Clinic (IL).Methods: Chart analysis was performed on 1095 patients, without prior glaucoma or OHT, who received unilateral anti-VEGF injections for AMD from 2005 to 2012, with data collected through 2013. Data collection included demographics, lens status, date and medication type of each injection, and the date of diagnosis of glaucoma or OHT by a treating glaucoma specialist, which was the main outcome measure. Rare events logistic regression was performed to determine the risk of disease development based on sex, lens status, and injection frequency.Results: Unilateral glaucoma or sustained OHT developed in 42 patients over the course of follow-up, with 40 events in the injected eye only, 2 in the contralateral eye only. Statistical modeling predicted elevated risk for onset of glaucomatous disease with a higher maximum frequency of injections (p < 0.0001, odds ratio [OR] 2.18 for each additional injection over the most injection-intense 6 months for a given subject) and with phakic lens status (p = 0.0009, OR 0.33 for pseudophakia).Conclusion: Our results show a significant risk for glaucoma or OHT development in patients undergoing repeated treatments with intravitreal anti-VEGF injections for AMD, establishing the first reliable connection between disease development and a period of high-frequency injections. In addition, we show a significantly increased risk of disease development in phakic patients, which we believe points to a mechanical explanation for this type of secondary glaucoma.Keywords: exudative macular degeneration, secondary glaucoma, open-angle glaucoma, anti-vascular endothelial growth factorWingard JBDelzell DAPHoulihan NVLin JGieser JPDove Medical Pressarticleexudative macular degeneration secondary glaucoma open-angle glaucoma anti-vascular endothelial growth factorOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 2563-2572 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	exudative macular degeneration secondary glaucoma open-angle glaucoma anti-vascular endothelial growth factor Ophthalmology RE1-994
spellingShingle	exudative macular degeneration secondary glaucoma open-angle glaucoma anti-vascular endothelial growth factor Ophthalmology RE1-994 Wingard JB Delzell DAP Houlihan NV Lin J Gieser JP Incidence of Glaucoma or Ocular Hypertension After Repeated Anti-Vascular Endothelial Growth Factor Injections for Macular Degeneration
description	Jeremy B Wingard,1 Darcie AP Delzell,2 Nathan V Houlihan,2 Jonathan Lin,2 Jon P Gieser1 1Wheaton Eye Clinic, Wheaton, IL 60187, USA; 2Mathematics and Computer Science Department, Wheaton College, Wheaton, IL, 60187, USACorrespondence: Jeremy B WingardWheaton Eye Clinic, 2015 N. Main Street, Wheaton, IL 60187, USATel +1 630-668-8250Email jbwingard@gmail.comPurpose: To estimate the risk of glaucoma or sustained ocular hypertension (OHT) related to anti-vascular endothelial growth factor (VEGF) injections for age-related macular degeneration (AMD).Design: Retrospective chart review.Subjects: Patients who received unilateral anti-VEGF injections for AMD at the Wheaton Eye Clinic (IL).Methods: Chart analysis was performed on 1095 patients, without prior glaucoma or OHT, who received unilateral anti-VEGF injections for AMD from 2005 to 2012, with data collected through 2013. Data collection included demographics, lens status, date and medication type of each injection, and the date of diagnosis of glaucoma or OHT by a treating glaucoma specialist, which was the main outcome measure. Rare events logistic regression was performed to determine the risk of disease development based on sex, lens status, and injection frequency.Results: Unilateral glaucoma or sustained OHT developed in 42 patients over the course of follow-up, with 40 events in the injected eye only, 2 in the contralateral eye only. Statistical modeling predicted elevated risk for onset of glaucomatous disease with a higher maximum frequency of injections (p < 0.0001, odds ratio [OR] 2.18 for each additional injection over the most injection-intense 6 months for a given subject) and with phakic lens status (p = 0.0009, OR 0.33 for pseudophakia).Conclusion: Our results show a significant risk for glaucoma or OHT development in patients undergoing repeated treatments with intravitreal anti-VEGF injections for AMD, establishing the first reliable connection between disease development and a period of high-frequency injections. In addition, we show a significantly increased risk of disease development in phakic patients, which we believe points to a mechanical explanation for this type of secondary glaucoma.Keywords: exudative macular degeneration, secondary glaucoma, open-angle glaucoma, anti-vascular endothelial growth factor
format	article
author	Wingard JB Delzell DAP Houlihan NV Lin J Gieser JP
author_facet	Wingard JB Delzell DAP Houlihan NV Lin J Gieser JP
author_sort	Wingard JB
title	Incidence of Glaucoma or Ocular Hypertension After Repeated Anti-Vascular Endothelial Growth Factor Injections for Macular Degeneration
title_short	Incidence of Glaucoma or Ocular Hypertension After Repeated Anti-Vascular Endothelial Growth Factor Injections for Macular Degeneration
title_full	Incidence of Glaucoma or Ocular Hypertension After Repeated Anti-Vascular Endothelial Growth Factor Injections for Macular Degeneration
title_fullStr	Incidence of Glaucoma or Ocular Hypertension After Repeated Anti-Vascular Endothelial Growth Factor Injections for Macular Degeneration
title_full_unstemmed	Incidence of Glaucoma or Ocular Hypertension After Repeated Anti-Vascular Endothelial Growth Factor Injections for Macular Degeneration
title_sort	incidence of glaucoma or ocular hypertension after repeated anti-vascular endothelial growth factor injections for macular degeneration
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/bd57ea1c0f8344c38c7dfa48bd94ad6c
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Incidence of Glaucoma or Ocular Hypertension After Repeated Anti-Vascular Endothelial Growth Factor Injections for Macular Degeneration

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