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RetinaOctober 20150 citations

INCIDENCE OF SUSTAINED OCULAR HYPERTENSION USING PREPACKAGED VERSUS FRESHLY PREPARED INTRAVITREAL BEVACIZUMAB FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

Storey Philip P, Ho Vincent, Yeh Steven, Reddy Sahitya, Fang-Yen Natalie Hsiao, Pequignot Edward, Leiby Benjamin E, Fineman Mitchell, Garg Sunir, Hubbard G Baker


AI Summary

This study found sustained ocular hypertension after bevacizumab injections is rare, with a non-significant trend toward higher rates using prepackaged versus freshly prepared drug.

Abstract

Purpose

To compare the incidence of sustained ocular hypertension (OHT) after intravitreal injections of prepackaged versus freshly prepared bevacizumab monotherapy for the treatment of neovascular age-related macular degeneration.

Methods

Charts of 1,216 patients with neovascular age-related macular degeneration receiving intravitreal bevacizumab monotherapy at 2 retina practices using different preparations of bevacizumab between January 1, 2009, and December 31, 2011, were reviewed. Primary outcome was incidence of sustained OHT, defined as intraocular pressure > 25 mmHg with an increase ≥ 6 from baseline on ≥ 2 consecutive visits or requiring treatment.

Results

A total of 6,479 injections in 740 eyes of 634 patients were included and 14 eyes (0.81% incidence per eye-year) developed sustained OHT. For eyes receiving prepackaged bevacizumab, 10 of 339 eyes (1.39% incidence per eye-year) developed sustained OHT compared with 4 of 401 eyes (0.39% incidence per eye-year) receiving freshly prepared bevacizumab, giving an incidence rate ratio of 3.55 (95% confidence interval, 0.93-13.49; P = 0.063). All eyes that developed sustained OHT achieved intraocular pressure control with observation or topical therapy alone.

Conclusion

Incidence of sustained OHT after intravitreal bevacizumab is low. We found a trend toward higher rates of sustained OHT with prepackaged bevacizumab although this difference was not statistically or clinically significant.


MeSH Terms

AgedAged, 80 and overAngiogenesis InhibitorsBevacizumabDrug CompoundingDrug PackagingFemaleFollow-Up StudiesHumansIncidenceIntraocular PressureIntravitreal InjectionsMaleMiddle AgedOcular HypertensionRisk FactorsTonometry, OcularVascular Endothelial Growth Factor AWet Macular Degeneration

Key Concepts5

The incidence of sustained ocular hypertension (OHT), defined as intraocular pressure > 25 mmHg with an increase ≥ 6 from baseline on ≥ 2 consecutive visits or requiring treatment, was 0.81% per eye-year (14 eyes) among 740 eyes of 634 patients receiving intravitreal bevacizumab for neovascular age-related macular degeneration.

EpidemiologyCohortRetrospective Cohort Studyn=740 eyes of 634 patientsCh10

For eyes receiving prepackaged intravitreal bevacizumab for neovascular age-related macular degeneration, 10 of 339 eyes (1.39% incidence per eye-year) developed sustained ocular hypertension (OHT).

PrognosisCohortRetrospective Cohort Studyn=339 eyesCh10

For eyes receiving freshly prepared intravitreal bevacizumab for neovascular age-related macular degeneration, 4 of 401 eyes (0.39% incidence per eye-year) developed sustained ocular hypertension (OHT).

PrognosisCohortRetrospective Cohort Studyn=401 eyesCh10

There was a trend toward higher rates of sustained ocular hypertension (OHT) with prepackaged intravitreal bevacizumab compared to freshly prepared bevacizumab for neovascular age-related macular degeneration, with an incidence rate ratio of 3.55 (95% confidence interval, 0.93-13.49; P = 0.063), though this difference was not statistically or clinically significant.

Comparative EffectivenessCohortRetrospective Cohort Studyn=740 eyesCh10

A retrospective chart review of 1,216 patients with neovascular age-related macular degeneration receiving intravitreal bevacizumab monotherapy between January 1, 2009, and December 31, 2011, was conducted to compare the incidence of sustained ocular hypertension (OHT) after intravitreal injections of prepackaged versus freshly prepared bevacizumab.

MethodologyCohortRetrospective Cohort Studyn=1,216 patientsCh10

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