Intraocular Pressure After Anti-Vascular Endothelial Growth Factor Injection in Eyes With a Mineralized Bruch's Membrane Caused by Pseudoxanthoma Elasticum.
Raming Kristin, Saltenberger Isabel, Meinke Jonathan, Risseeuw Sara, Mercieca Karl, Herrmann Philipp, Chang Petrus, Ach Thomas, van Leeuwen Redmer, Ossewaarde-van Norel Jeannette
AI Summary
This study found PXE patients have a longer time for intraocular pressure to normalize after anti-VEGF injections, suggesting a need for pre-injection IOP-lowering strategies due to potential vulnerability.
Abstract
Purpose
To assess acute IOP changes after anti-VEGF injections in patients with Pseudoxanthoma elasticum (PXE) compared to other retinal diseases.
Methods
Twenty eyes of patients with PXE (mean age 63.4 ± 6.4 years) and 30 control eyes (mean age 64.8 ± 11.8 years) were included. IOP was measured prior and one, five, and 15 minutes after intravitreal injection of 50 µL anti-VEGF agent. The post-injection IOP curve was modeled by an exponential decay function, and the resulting exponential time constant (tau) served as the outcome variable in the multivariable models.
Results
IOP raised markedly after anti-VEGF injection in both groups, without significant difference in PXE compared to controls. The median tau in the PXE group was 8.6 minutes (interquartile range [IQR] = 8.2-9.4) versus 7.6 minutes (IQR = 6.8-8.9) in the control group (P = 0.02). Seven PXE patients and one control patient reported a previous transient vision loss after anti-VEGF injection. Univariate analysis showed that the diagnosis of PXE (1.12, P = 0.006), angioid streak length (0.12, P = 0.01), prior transient vision loss (1.77, P = 0.001), peripheral artery disease (0.96, P = 0.04) and the number of previous anti-VEGF injections (0.02, P = 0.014) were significantly associated with higher tau values.
Conclusions
The time to restore to baseline IOP after anti-VEGF injection is longer in PXE patients. Given the early need for anti-VEGF treatment, frequent injections, and the possible heightened vulnerability (e.g., optic disc drusen) in PXE patients, clinical trials on pre-injection IOP-lowering measures warrant consideration.
MeSH Terms
Shields Classification
Key Concepts4
The median exponential time constant (tau) for intraocular pressure (IOP) restoration after anti-VEGF injection in patients with Pseudoxanthoma elasticum (PXE) was 8.6 minutes (interquartile range [IQR] = 8.2-9.4) compared to 7.6 minutes (IQR = 6.8-8.9) in control patients (P = 0.02).
Intraocular pressure (IOP) raised markedly after anti-VEGF injection in both Pseudoxanthoma elasticum (PXE) patients and control patients, without a significant difference between the groups.
Univariate analysis showed that a diagnosis of Pseudoxanthoma elasticum (PXE) (1.12, P = 0.006), angioid streak length (0.12, P = 0.01), prior transient vision loss (1.77, P = 0.001), peripheral artery disease (0.96, P = 0.04), and the number of previous anti-VEGF injections (0.02, P = 0.014) were significantly associated with higher exponential time constant (tau) values for IOP restoration after anti-VEGF injection.
Seven patients with Pseudoxanthoma elasticum (PXE) and one control patient reported previous transient vision loss after anti-VEGF injection.
Related Articles5
Short-term intraocular pressure changes after intravitreal aflibercept 2 mg, aflibercept 8 mg and faricimab: a prospective, comparative study.
Observational StudyProphylactic intraocular pressure lowering measures in anti-vascular endothelial growth factor therapy: A systematic review and meta-analysis.
Systematic ReviewIntraocular pressure effect of anti-vascular endothelial growth factor injection for aggressive posterior retinopathy of prematurity.
Cohort StudyIntraocular pressure decreases in eyes with glaucoma-related diagnoses after conversion to aflibercept for treatment-resistant age-related macular degeneration.
Case SeriesIntraocular Pressure Changes and Vascular Endothelial Growth Factor Inhibitor Use in Various Retinal Diseases: Long-Term Outcomes in Routine Clinical Practice: Data from the Fight Retinal Blindness! Registry.
Observational StudyIs this article assigned to the wrong chapter(s)? Let us know.