To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Ranibizumab Injections Cause Spikes in Intraocular Pressure: Presented at AAO URL: http://www.pslgroup.com/dg/21713E.htm Doctor's Guide November 13, 2007
By Earl R. Nichols NEW ORLEANS, LA -- November 13, 2007 -- Patients who receive injections of ranibizumab to treat age-related macular degeneration could run the risk of dangerous spikes in intraocular pressure (IOP). This effect of the drug could put these patients at risk of damage to the optic nerve head, researchers reported here at the annual meeting of the American Academy of Ophthalmology (AAO). The spikes in IOP are transient, but substantial, the researchers noted. And while the risk of optic nerve damage is not certain, owing to the relatively short duration of the IOP increase, this is the kind of pressure increase that it is best to avoid in patients with pre-existing glaucoma or elevated IOP, Ronald Frenkel, MD, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States, during a poster presentation here on November 9. In Dr. Frenkel's study, 55 patients with a mean age of 79 years (seven with pre-existing glaucoma) were given one injection each of 0.05 mL ranibizumab. One hour before the ranibizumab injection, half of the subjects were given ocular hypotensive eye-drops in an attempt to counteract the IOP spike. IOP measurements were taken within 1 minute of the ranibizumab injection, and then every 5 to 10 minutes until the IOP returned to a safe level. Mean preinjection IOP was 13 mm Hg and increased to 38 mm Hg 1 minute after the injection. The IOP started to fall almost immediately, however, and decreased to 28 mm Hg within 3 minutes. IOP decreased further to 23 mm Hg between 11 and 20 minutes postinjection, and was reduced to 18 mm Hg at 21 to 30 minutes postinjection. In most patients, IOP decreased significantly by the 30-minute time point, the authors reported, and by the time of the next injection, IOPs returned to original baseline levels within 3 minutes in all patients. Interestingly, there was no difference in IOP measurements between patients who had glaucoma and those who did not. Nor was there a difference in how much the IOP increased, regardless of whether the patients were pretreated with ocular hypotensive medications. The authors stressed that although this study looked only at IOP following a single injection, the increase was enough to raise concern for patients with macular degeneration who might require such injections on a monthly basis. "Patients are scheduled to receive injections every 4 weeks, and thus recurring IOP spikes may be damaging to the optic nerve, particularly in patients with advanced glaucoma. The risk of recurrent injections in such patients must be weighed carefully and may pose a relative contraindication," Dr. Frenkel said. Caution should also be exercised in hyperopic patients, whose eyes have a shorter axial length, and who therefore might be at even more risk of IOP increases, he added. "At this time, the long-term effects of repeated intravitreal injections resulting in IOP spikes, with secondary induced ischaemia, are unclear. However, further study is warranted, particularly in vascularly compromised eyes, such as those with macular degeneration, diabetes, or glaucoma," he concluded. [Presentation title: Are Recurrent Transient Rises in IOP a Concern for Patients Following Intravitreal Injections of Ranibizumab (Lucentis)? PO320] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.