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Wet age-related macular degeneration

Frequent intravitreal bevacizumab injections increase risk of glaucoma surgery

Seven or more injections a year makes patients more than twice as likely to need glaucoma surgery, according to researchers.

Intravitreous injections of antivascular endothelial growth factor (VEGF) agents, such as bevacizumab, are associated with an increase in intraocular pressure, which could potentially lead to a higher rate of glaucoma surgery.

To investigate, researchers compared patients in British Columbia treated with bevacizumab for wet age-related macular degeneration (AMD) over a four-year period: 74 who underwent glaucoma surgery and 740 controls who did not.

The team found that patients who had seven or more injections per year were 2.5 times more likely to undergo glaucoma surgery than those who received three or fewer injections per year (95% confidence interval (CI) 1.25–4.93). Those who received four to six injections annually were 1.7 times more likely to have surgery (95% CI 0.84–3.23).

Reporting in JAMA Ophthalmology[1] (online, 16 March 2017), the team says that physicians should be aware of this potential relationship between repeated intravitreal anti-VEGF injections and the need for glaucoma surgery.

Citation: Clinical Pharmacist DOI: 10.1211/CP.2017.20202565

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