DOI: 10.1177/25158414261416832 ISSN: 2515-8414

Effects of recurrent aflibercept and ranibizumab on intraocular pressure in diabetic retinopathy and age-related macular degeneration

Güvenç Toprak, Serdal Çelebi, Fatih Ulaş
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Background:

Age-related macular degeneration (AMD) and diabetic retinopathy (DR) are major causes of vision loss and are both associated with elevated vascular endothelial growth factor (VEGF) levels. Repeated intravitreal anti-VEGF injections may affect intraocular pressure (IOP) and vitreous reflux differently in these conditions.

Objectives:

This study aimed to compare the effects of repeated anti-VEGF injections (>10) on IOP and vitreous reflux in patients with AMD and DR.

Design:

Single-center cross-sectional observational comparative study.

Methods:

Patients diagnosed with AMD or DR who received repeated intravitreal aflibercept or ranibizumab injections were included. IOP was measured before and after injections. Additional evaluated parameters included conjunctival bleb diameter, lens status, and the presence of pseudoexfoliation (PEX).

Results:

Patients with AMD were significantly older than those with DR ( p  < 0.001). Post-injection IOP was significantly lower in the AMD group ( p  = 0.023), which was attributed to increased vitreous reflux associated with age-related vitreous liquefaction. Conjunctival bleb diameter was significantly larger in AMD patients ( p  = 0.032). No significant differences were observed between the aflibercept and ranibizumab groups. Post-injection IOP was significantly associated with pseudophakia and conjunctival bleb diameter ( p  = 0.011 and p  < 0.001), but not with the number of injections or the presence of PEX ( p  = 0.347 and p  = 0.776).

Conclusion:

Patients with AMD receiving repeated intravitreal aflibercept or ranibizumab injections exhibited larger conjunctival bleb diameters and lower post-injection IOP compared with patients with DR, likely due to increased vitreous reflux related to age-associated vitreous liquefaction. No statistically significant difference in IOP elevation was observed between the aflibercept and ranibizumab treatment groups.

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