Effect of prophylactic timolol 0.1% gel on intraocular pressure after an intravitreal injection of ranibizumab: a randomized study

Alfredo Pece,1 Davide Allegrini,1 Giovanni Montesano,2 Andrea Fabio Dimastrogiovanni1 1Eye Clinic, Melegnano Hospital, Vizzolo Predabissi, 2Eye Clinic, San Paolo Hospital, Università di Milano, Milano, Italy Purpose: The purpose of this study is to make a prospective evaluation of the e...

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Autores principales:	Pece A, Allegrini D, Montesano G, Dimastrogiovanni AF
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Macular edema intravitreal injection timolol 0.1% gel pressure spikes. Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/c4b5d299b233447aba5ecd7a9356be6f
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spelling	oai:doaj.org-article:c4b5d299b233447aba5ecd7a9356be6f2021-12-02T02:30:56ZEffect of prophylactic timolol 0.1% gel on intraocular pressure after an intravitreal injection of ranibizumab: a randomized study1177-5483https://doaj.org/article/c4b5d299b233447aba5ecd7a9356be6f2016-06-01T00:00:00Zhttps://www.dovepress.com/effect-of-prophylactic-timolol-01-gel-on-intraocular-pressure-after-an-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Alfredo Pece,1 Davide Allegrini,1 Giovanni Montesano,2 Andrea Fabio Dimastrogiovanni1 1Eye Clinic, Melegnano Hospital, Vizzolo Predabissi, 2Eye Clinic, San Paolo Hospital, Università di Milano, Milano, Italy Purpose: The purpose of this study is to make a prospective evaluation of the effect of timolol 0.1% eye gel on short-term intraocular pressure (IOP) after an intravitreal injection (IVI) of ranibizumab. Participants and methods: One hundred and fifty eyes of 150 IVI-naïve patients with macular edema caused by various pathological conditions (age-related macular degeneration, central or branch retinal vein occlusion, and diabetic retinopathy) were scheduled to undergo an IVI of ranibizumab (0.5 mg/0.05 cc). The patients were randomly divided into three groups: 50 were not treated with timolol before the IVI (group 1); 50 received an instillation of timolol 0.1% eye gel the evening before the IVI (group 2); and 50 received an instillation of timolol 0.1% eye gel 2 hours before the IVI (group 3). The incidence of clinically significant intraocular hypertensive spikes (>25 mmHg and >40 mmHg) was then assessed. Results: Our findings showed that mean IOP at baseline was significantly higher than at both 5 and 60 minutes after IVI (P<0.01). Spikes of >25 mmHg were recorded at either time in 27 patients (54%) in group 1, 23 patients (44%) in group 2, and 24 patients (48%) in group 3. None of the between-group differences were significant. Spikes of >40 mmHg (which were only detected 5 minutes after IVI) were recorded in nine (18%), eight (16%), and one patient (2%) in groups 1, 2, and 3, respectively. The only significant difference was between the control and group 3 (P=0.012). Conclusion: An increase in IOP after antivascular endothelial growth factor IVI is a frequent complication. The prophylactic use of timolol 0.1% gel effectively reduced the mean IOP when administered 2 hours before IVI and was also effective in preventing dangerous IOP spikes of >40 mmHg. It is therefore recommended before IVIs as a means of preventing emergency procedures and preserving the health of the optic nerve. Keywords: macular edema, pressure spikes, anti-VEGF therapy, pressure-lowering medicationPece AAllegrini DMontesano GDimastrogiovanni AFDove Medical PressarticleMacular edemaintravitreal injectiontimolol 0.1% gelpressure spikes.OphthalmologyRE1-994ENClinical Ophthalmology, Vol 2016, Iss Issue 1, Pp 1131-1138 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Macular edema intravitreal injection timolol 0.1% gel pressure spikes. Ophthalmology RE1-994
spellingShingle	Macular edema intravitreal injection timolol 0.1% gel pressure spikes. Ophthalmology RE1-994 Pece A Allegrini D Montesano G Dimastrogiovanni AF Effect of prophylactic timolol 0.1% gel on intraocular pressure after an intravitreal injection of ranibizumab: a randomized study
description	Alfredo Pece,1 Davide Allegrini,1 Giovanni Montesano,2 Andrea Fabio Dimastrogiovanni1 1Eye Clinic, Melegnano Hospital, Vizzolo Predabissi, 2Eye Clinic, San Paolo Hospital, Università di Milano, Milano, Italy Purpose: The purpose of this study is to make a prospective evaluation of the effect of timolol 0.1% eye gel on short-term intraocular pressure (IOP) after an intravitreal injection (IVI) of ranibizumab. Participants and methods: One hundred and fifty eyes of 150 IVI-naïve patients with macular edema caused by various pathological conditions (age-related macular degeneration, central or branch retinal vein occlusion, and diabetic retinopathy) were scheduled to undergo an IVI of ranibizumab (0.5 mg/0.05 cc). The patients were randomly divided into three groups: 50 were not treated with timolol before the IVI (group 1); 50 received an instillation of timolol 0.1% eye gel the evening before the IVI (group 2); and 50 received an instillation of timolol 0.1% eye gel 2 hours before the IVI (group 3). The incidence of clinically significant intraocular hypertensive spikes (>25 mmHg and >40 mmHg) was then assessed. Results: Our findings showed that mean IOP at baseline was significantly higher than at both 5 and 60 minutes after IVI (P<0.01). Spikes of >25 mmHg were recorded at either time in 27 patients (54%) in group 1, 23 patients (44%) in group 2, and 24 patients (48%) in group 3. None of the between-group differences were significant. Spikes of >40 mmHg (which were only detected 5 minutes after IVI) were recorded in nine (18%), eight (16%), and one patient (2%) in groups 1, 2, and 3, respectively. The only significant difference was between the control and group 3 (P=0.012). Conclusion: An increase in IOP after antivascular endothelial growth factor IVI is a frequent complication. The prophylactic use of timolol 0.1% gel effectively reduced the mean IOP when administered 2 hours before IVI and was also effective in preventing dangerous IOP spikes of >40 mmHg. It is therefore recommended before IVIs as a means of preventing emergency procedures and preserving the health of the optic nerve. Keywords: macular edema, pressure spikes, anti-VEGF therapy, pressure-lowering medication
format	article
author	Pece A Allegrini D Montesano G Dimastrogiovanni AF
author_facet	Pece A Allegrini D Montesano G Dimastrogiovanni AF
author_sort	Pece A
title	Effect of prophylactic timolol 0.1% gel on intraocular pressure after an intravitreal injection of ranibizumab: a randomized study
title_short	Effect of prophylactic timolol 0.1% gel on intraocular pressure after an intravitreal injection of ranibizumab: a randomized study
title_full	Effect of prophylactic timolol 0.1% gel on intraocular pressure after an intravitreal injection of ranibizumab: a randomized study
title_fullStr	Effect of prophylactic timolol 0.1% gel on intraocular pressure after an intravitreal injection of ranibizumab: a randomized study
title_full_unstemmed	Effect of prophylactic timolol 0.1% gel on intraocular pressure after an intravitreal injection of ranibizumab: a randomized study
title_sort	effect of prophylactic timolol 0.1% gel on intraocular pressure after an intravitreal injection of ranibizumab: a randomized study
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/c4b5d299b233447aba5ecd7a9356be6f
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Effect of prophylactic timolol 0.1% gel on intraocular pressure after an intravitreal injection of ranibizumab: a randomized study

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