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Effects of intravitreal injection of bevacizumab with or without anterior chamber paracentesis on intraocular pressure and peripapillary retinal nerve fiber layer thickness: a prospective study

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To investigate the effects of intravitreal injection of bevacizumab (IVB) with or without anterior chamber paracentesis on intraocular pressure (IOP) and peripapillary retinal nerve fiber layer (PRNFL) thickness.

Methods

In this prospective randomized clinical trial, 90 eyes with center involving diabetic macular edema or wet type age-related macular degeneration (AMD) were randomly assigned to receive IVB either without (group A) or with (group B) anterior chamber paracentesis. IOP was measured before and within 2 min, 30 min, 24 hours and 3 months after injections. Peripapillary spectral-domain optical coherence tomography (SD-OCT) was performed before and 3 months after injections.

Results

Mean IOP changes 2 minutes, 30 minutes, 24 hours, and 3 months after injections were 26.4 ± 5.7 mmHg (P < 0.001), 6.5 ± 6.3 mmHg (P < 0.001), 0.2 ± 2.9 mmHg (P > 0.99) and 0.5 ± 2.4 mmHg (P > 0.99) in group A and −1.3 ± 2.4 mmHg (P < 0.001), −3.2 ± 1.8 mmHg (P < 0.001), −3.1 ± 1.8 mmHg (P < 0.001) and −1.8 ± 2.2 mmHg (P < 0.001) in group B, respectively Mean baseline average PRNFL thickness was 85.3±5.6 μm and 85.6 ± 5 μm in groups A and B respectively. Mean PRNFL thickness changes after 3 month was −2 ± 2 μm (P < 0.001) in group A and 0 ± 2 μm (P = 0.101) in group B. Mean PRNFL thickness in group A decreased more than group B (P < 0.001).

Conclusion

Conventional method of IVB injection was associated with acute IOP rise and significant PRNFL loss 3 months after injection. Anterior chamber paracentesis prevents acute IOP rise and PRNFL loss.

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Acknowledgements

The authors have full control of all primary data, and they agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review their data upon request.

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Authors and Affiliations

  1. Ophthtalmic Research Center, Shahid Beheshti University of Medical Sciences, Labbafinejad Medical Center, Tehran, Iran

    Masoud Soheilian, Talieh Montahae & Seyed Aliasghar Mosavi

  2. Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Torfeh Eye Hospital, Baharestan St, Tehran, Iran

    Saeed Karimi & Homayoun Nikkhah

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  1. Masoud Soheilian
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  2. Saeed Karimi
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  3. Talieh Montahae
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Correspondence to Saeed Karimi.

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No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

The study was carried out after receiving the approval of the research ethics committee of Shahid Beheshti University of Medical Sciences, and was in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Soheilian, M., Karimi, S., Montahae, T. et al. Effects of intravitreal injection of bevacizumab with or without anterior chamber paracentesis on intraocular pressure and peripapillary retinal nerve fiber layer thickness: a prospective study. Graefes Arch Clin Exp Ophthalmol 255, 1705–1712 (2017). https://doi.org/10.1007/s00417-017-3702-1

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  • DOI: https://doi.org/10.1007/s00417-017-3702-1

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