Intraocular Pressure Changes After Intravitreal Bevacizumab Injection Alone or Combination of Bevacizumab and Triamcinolone Acetonide

Nour Yasser Barakat; Yusuf Suleiman; Kahtan Jalloul

doi:doi:10.11648/j.ijhnm.20200602.11

| Peer-Reviewed

Intraocular Pressure Changes After Intravitreal Bevacizumab Injection Alone or Combination of Bevacizumab and Triamcinolone Acetonide

Nour Yasser Barakat, Yusuf Suleiman, Kahtan Jalloul

Published in International Journal of Homeopathy & Natural Medicines (Volume 6, Issue 2)

Received: 31 July 2020 Accepted: 12 August 2020 Published: 11 December 2020

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Aim: To evaluate intraocular pressure changes after intravitreal injection of Bevacizumab alone or in combination with Triamcinolone Acetonide. Method: Our study included 63 eyes from the ophthalmology department at Tishreen University Hospital who had vascular retinal diseases. The patients were divided into two groups according to the indication of injection. The first group was injected with bevacizumab (B) at a concentration of 2.5mg / 0.1 ml and the second group was injected with the combination treatment of Triamcinolone Acetonide at a concentration of 2mg / 0.05ml with bevacizumab (B+TA) at a concentration of 1.25mg/ 0.05ml. Intraocular pressure was monitored on the Goldman applanation tonometry and values were recorded as follows: before injection, the second injection day, a week after injection, a month after injection and after three months. Results: The mean values of the intraocular pressure mean increased from the second day of injection in the study groups (B) and (B+TA) and the mean of the IOP values before injection (13.34-13.31 mmHg) respectively, and the IOP values showed the maximum in both groups after a week of the injection (17.81-17.31 mmHg) then began to decrease after a month and three months later to (17.34-17.06mmHg) and (17.6-16.75mmHg) mercury respectively, but they remained higher than they were before the injection, and the number of injections had no effect on intraocular pressure. Conclusion: intravitreal injections with both bevacizumab alone or in combination with triamcinolone acetonide resulted in a rise in intraocular pressure, and differences in pressure values were statistically significant within the same group during the studied time periods but were not statistically significant between the two groups, and the number of injections had no effect on intraocular pressure.

Published in	International Journal of Homeopathy & Natural Medicines (Volume 6, Issue 2)
DOI	10.11648/j.ijhnm.20200602.11
Page(s)	6-14
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Bevacizumab, Triamcinolone Acetonide, Intraocular Pressure

References

[1]	Brand CS. Management of retinal vascular diseases: A patient-centric approach. Eye (Lond) 2012; 26 (Suppl 2): S1-S16.
[2]	Cheung N, Mitchell P, Wong TY. Diabetic retinopathy. Lancet 2010; 376: 124-136.
[3]	Hikichi T, Higuchi M, Matsushita T, Kosaka S, Matsushita R, Takami K et al. Two-year outcomes of intravitreal bevacizumab therapy for macular oedema secondary to branch retinal vein occlusion. Br J Ophthalmol 2014; 98 (2): 195–199.
[4]	Jong Wook Lee, Hoon Park, Jeong Han Choi, Hyun Joo Lee, Sang Woong Moon, Ja Heon Kang, and Young Gyun Kim. Short-term changes of intraocular pressure and ocular perfusion pressure after intravitreal injection of bevacizumab or ranibizumabBMC Ophthalmol. 2016; 16: 69.
[5]	Manousaridis K, Talks J. Macular ischaemia: a contraindication for anti-VEGF treatment in retinal vascular disease? Br J Ophthalmol. 2012; 96 (2): 179–184.
[6]	Valentina Sarao, Daniele Veritti, Francesco Boscia, and Paolo Lanzetta. Intravitreal Steroids for the Treatment of Retinal Diseases. Scientific World Journal. 2014; 2014: 989501.
[7]	K Kriechbaum, S Prager, G Mylonas, C Scholda, G Rainer, M Funk, M Kundi, U Schmidt-Erfurth, Intravitreal bevacizumab (Avastin) versus triamcinolone (Volon A) for treatment of diabetic macular edema: one year results. The Scientific Journal of the Royal College of Ophthalmologists. 2014 Jan; 28 (1): 9–16.
[8]	Fung AE, Rosenfeld PJ, Reichel E. The Intrnational Intravitreal Bevacizumab Safety Survery: using the internet to assess drug safty worldwide. J Ophthalmol 2006, 90: 1344-9.
[9]	Mason JO 3^rd, Albert MA Jr, Vial R. Intravitreal bevacizumab (Avastin) for refractory pseudophakic cystoid macular edema. Retina 2006, 26: 356-7.
[10]	Bakri SJ, Snyder MR, Reid JM, Pulido JS, Singh RJ. Pharmacokinetics of intravitreal bevacizumab (Avastin). Ophthalmology 2007; 114 (5): 855–859.
[11]	Gillies MC, Sutter FK, Simpson JM, Larsson J, Ali H, Zhu M. Intravitreal triamcinolone for refractory diabetic macular edema: Tow-year results of a double masked, placebo-controlled, randomized clinical trial. Ophthalmology 2006, 133: 1533-8.
[12]	McCuen BW2nd, Bessler M, Tano Y, Chandler D, Machemer R. The lack of toxicity of intravitreally administered triamcinolone acetonide. Am J Ophthalmol 1981, 91: 7858.
[13]	Sampat KM, Garg SJ. Complications of intravitreal injections. Curr Opin Ophthalmol 2010; 21 (3): 178-183.
[14]	George Kampougeris, Dimitrios Spyropoulos, and Adrianna Mitropoulou. Intraocular Pressure rise after Anti-VEGF Treatment: Prevalence, Possible Mechanisms and Correlations. Journal of Current Glaucoma Practice. 2013 Jan-Apr; 7 (1): 19–24.
[15]	Aref AA: Management of immediate and sustained intraocular pressure rise associated with intravitreal antivascular endothelial growth factor injection therapy. Curr Opin Ophthalmol 2012; 23: 105–110.
[16]	Weerawat Kiddee, Mayuree Montriwet. Intraocular Pressure Changes in Non-Glaucomatous Patients Receiving Intravitreal Anti-Vascular Endothelial Growth Factor Agents. Published: September 11, 2015.
[17]	Michelson G, Groh MJ, Langhans M: Perfusion of the juxtapapillary retina and optic nerve head in acute ocular hypertension. Ger J Ophthalmol 1996; 5: 315–321.
[18]	Pershing S, Bakri SJ, Moshfeghi DM. Ocular hypertension and intraocular pressure asymmetry after intravitreal injection of antivascular endothelial growth factor agents. Ophthalmic Surg Lasers Imaging Retina. 2013 Sep-Oct; 44 (5): 460-4. Doi: 10.3928/23258160-20130909-07.
[19]	Sulman Jaffar, Ali Tayyab, Zeba I Matin, Amena Masrur, Rehan Naqaish. EFFECT OF INTRA VITREAL INJECTION OF BEVACIZUMAB ON INTRA-OCULAR PRESSURE. J Ayub Med Coll Abbottabad 2016; 28 (2): 360–3.
[20]	Mehmet OZGUR CUBUK, Erkan UNSAL. Intraocular Pressure Changes in Eyes Treated with Intravitreal Injections of Anti-Vascular Endothelial Growth Factor for Age Related Macular Degeneration: The Results of Real Worlds. Retina-Vitreus/Journal of Retina-Vitreous. 2019, Vol. 28 Issue 2, p165-170. 6p.
[21]	Behrooz Heydari, Saeed Reza Heydari, Gholamhossein Yaghoobi. Effect of Avastin on intraocular pressure before and after intravitreal injections. Journal of Surgery and Trauma 2016; 4 (3-4): 44-4.
[22]	Yogish S. Kamath, Ashish Rander, Shailaja B S3, Lavanya G. Rao, Sulatha V Bhandary. The intraocular pressure changes following intravitrealbevacizumab injections in an Indian population. DOI: 10.18231/2395-1451.2018.0020.
[23]	Ashiyana Nariani, Blake Williams, and Seenu M Hariprasad. Long –term effect of anti-vascular endothelial growth factor injections on intraocular pressure. Indian Journal of Ophthalmology. 2016 Sep, 64 (9): 643-647.
[24]	Mahmood Ali, Furqan Ahmad Khan, Sarah Zafar, Farah Akhtar. Short and long term intraocular pressure changes after intravitreal injections of triamcinolone acetonide and bevacizumab in diabetic macular edema. Rawal Medical Journal: Vol. 39. No. 4, Oct-Dec 2014.
[25]	Sibel Aksoy, Gursel Yilmaz, Imren Akkoyun, and Ayse Canan Yazici Comparison of intravitreal bevacizumab and triamcinolone acetonide theraphies for diffuse diabetic macular edema. International Journal of Ophthalmology International Journal of Ophthalmology, 18 Jun 2015, 8 (3): 550-555.
[26]	Matthew Sniegowski, Naresh Mandava, and Malik Y Kahook. Sustained Intraocular Pressure Elevation After Intravitreal Injection of Bevacizumab and Ranibizumab Associate with Trabeculitis. Published online 2010 Jun 22. Doi: 10.2174/1874364101004010028.
[27]	Kahook MY, Liu L, Ruzycki P, et al. High-molecular-weight aggregates in repackaged bevacizumab. Retina. 2010; 30: 887-89.
[28]	Singh RS, Kim JE. Ocular hypertension following intravitreal anti-vascular endothelial growth factor agents. Drugs Aging. 2012; 29: 949–56. [PubMed] [Google Scholar].
[29]	Ahmet taylan yazıcı C. Alagöz N. Alagöz et al. Intraocular pressure changes after different types of intravitreal injections for the treatment of macular edema. June 2011 • Retina-Vitreus 19 (2): 117-12.
[30]	Yong Woon Shin, MD, Hee Yoon Cho, MD, Yoon Jung Lee, MD, Min Chul Seong, MD. The Long-Term Observation of Intraocular Pressure after Intravitreal Injections of Bevacizumab, Triamcinolone, and Combination of Both. J Korean Ophthalmol Soc 2011; 52 (5): 574-581.
[31]	Sameh Mohamed Elgouhary, Hatem Mohamed Marey, Hoda Mohamed Elsobky, Esraa Samy. Intraocular Bevacizumab, Triamcinolone Acetonide or combination Treatment For Macular Edema Secondary to Branch Ritenal Vein Occlusion. INTRNATIONAL JOURNAL OF OPHTHALMIC RESEARCH 2015 June 1 (1): 24-27.
[32]	Golakiya HN, Hirapara HN, Parmar SJ, Naik VN, Tripathi CB. Triamcinolone Acetonide and Bevacizumab Induced Raised Intraocular Pressure in An Elderly Made Diabetic Patient –A Case Report. Curr Drug Saf. 2016, 11 (3): 270-1.
[33]	Clark AF, Wilson K, McCartney MD, Miggans ST, Kunkle M, Howe W. Glucocorticoid-induced formation of cross-linked actin networks in cultured human trabecular meshwork cells. Invest Ophthalmpl vis. sci1994; 35 (1): 281-294.
[34]	Sever Ozkan, Horozoglu Fatih, Celik Erkan, Topcu Birol. Intravitreal bevacizumab versus bevacizumab and 1mg triamcinolone acetonide in eyes with bilateral diabetic macular edema. Int Eye Sci, Vol. No 1, Jan. 2019.
[35]	Valerie C. Lerebours; Jane S. Myung, MD; Jesse N. Cohen; Ben Z. Cohen, MD. Intraocular Pressure In Eyes Treated With Intravitreal Combination Of 1mg Triamcinolone Acetonide And 1.25mg Bevacizumab. Investigative Ophthalmology & Visual Science March 2012, Vol. 53, 881.
[36]	Tze-Yi Chan, Cheng-Kuo Cheng. Intraocular Pressure changes after repeated intravitreal anti vascular endothelial growth factor injections in paitents with or without glaucoma. Taiwan Journal of Ophthalmology, March 2014, 28-32.
[37]	Falkenstein IA, Cheng L, Freeman WR. Changes of intraocular pressure after intravitreal injection of bevacizumab (avastin). Retina. 2007 Oct; 27 (8): 1044-7.
[38]	Yandan Zhou, Minwen Zhou, Shigang Xia, Qiancheng Jing, and Ling Gao. Sustained Elevation of Intraocular Pressure Associated with Intravitreal Administration of Anti-vascular Endothelial Growth Factor: A Systematic Review and Meta-Analysis. SCIENTIFIC REPORTS. 2016; 6: 39301.

Cite This Article

Plain Text BibTeX RIS

APA Style

Nour Yasser Barakat, Yusuf Suleiman, Kahtan Jalloul. (2020). Intraocular Pressure Changes After Intravitreal Bevacizumab Injection Alone or Combination of Bevacizumab and Triamcinolone Acetonide. International Journal of Homeopathy & Natural Medicines, 6(2), 6-14. https://doi.org/10.11648/j.ijhnm.20200602.11

Copy | Download

ACS Style

Nour Yasser Barakat; Yusuf Suleiman; Kahtan Jalloul. Intraocular Pressure Changes After Intravitreal Bevacizumab Injection Alone or Combination of Bevacizumab and Triamcinolone Acetonide. Int. J. Homeopathy Nat. Med. 2020, 6(2), 6-14. doi: 10.11648/j.ijhnm.20200602.11

Copy | Download

AMA Style

Nour Yasser Barakat, Yusuf Suleiman, Kahtan Jalloul. Intraocular Pressure Changes After Intravitreal Bevacizumab Injection Alone or Combination of Bevacizumab and Triamcinolone Acetonide. Int J Homeopathy Nat Med. 2020;6(2):6-14. doi: 10.11648/j.ijhnm.20200602.11

Copy | Download

@article{10.11648/j.ijhnm.20200602.11,
  author = {Nour Yasser Barakat and Yusuf Suleiman and Kahtan Jalloul},
  title = {Intraocular Pressure Changes After Intravitreal Bevacizumab Injection Alone or Combination of Bevacizumab and Triamcinolone Acetonide},
  journal = {International Journal of Homeopathy & Natural Medicines},
  volume = {6},
  number = {2},
  pages = {6-14},
  doi = {10.11648/j.ijhnm.20200602.11},
  url = {https://doi.org/10.11648/j.ijhnm.20200602.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijhnm.20200602.11},
  abstract = {Aim: To evaluate intraocular pressure changes after intravitreal injection of Bevacizumab alone or in combination with Triamcinolone Acetonide. Method: Our study included 63 eyes from the ophthalmology department at Tishreen University Hospital who had vascular retinal diseases. The patients were divided into two groups according to the indication of injection. The first group was injected with bevacizumab (B) at a concentration of 2.5mg / 0.1 ml and the second group was injected with the combination treatment of Triamcinolone Acetonide at a concentration of 2mg / 0.05ml with bevacizumab (B+TA) at a concentration of 1.25mg/ 0.05ml. Intraocular pressure was monitored on the Goldman applanation tonometry and values were recorded as follows: before injection, the second injection day, a week after injection, a month after injection and after three months. Results: The mean values of the intraocular pressure mean increased from the second day of injection in the study groups (B) and (B+TA) and the mean of the IOP values before injection (13.34-13.31 mmHg) respectively, and the IOP values showed the maximum in both groups after a week of the injection (17.81-17.31 mmHg) then began to decrease after a month and three months later to (17.34-17.06mmHg) and (17.6-16.75mmHg) mercury respectively, but they remained higher than they were before the injection, and the number of injections had no effect on intraocular pressure. Conclusion: intravitreal injections with both bevacizumab alone or in combination with triamcinolone acetonide resulted in a rise in intraocular pressure, and differences in pressure values were statistically significant within the same group during the studied time periods but were not statistically significant between the two groups, and the number of injections had no effect on intraocular pressure.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Intraocular Pressure Changes After Intravitreal Bevacizumab Injection Alone or Combination of Bevacizumab and Triamcinolone Acetonide
AU  - Nour Yasser Barakat
AU  - Yusuf Suleiman
AU  - Kahtan Jalloul
Y1  - 2020/12/11
PY  - 2020
N1  - https://doi.org/10.11648/j.ijhnm.20200602.11
DO  - 10.11648/j.ijhnm.20200602.11
T2  - International Journal of Homeopathy & Natural Medicines
JF  - International Journal of Homeopathy & Natural Medicines
JO  - International Journal of Homeopathy & Natural Medicines
SP  - 6
EP  - 14
PB  - Science Publishing Group
SN  - 2472-2316
UR  - https://doi.org/10.11648/j.ijhnm.20200602.11
AB  - Aim: To evaluate intraocular pressure changes after intravitreal injection of Bevacizumab alone or in combination with Triamcinolone Acetonide. Method: Our study included 63 eyes from the ophthalmology department at Tishreen University Hospital who had vascular retinal diseases. The patients were divided into two groups according to the indication of injection. The first group was injected with bevacizumab (B) at a concentration of 2.5mg / 0.1 ml and the second group was injected with the combination treatment of Triamcinolone Acetonide at a concentration of 2mg / 0.05ml with bevacizumab (B+TA) at a concentration of 1.25mg/ 0.05ml. Intraocular pressure was monitored on the Goldman applanation tonometry and values were recorded as follows: before injection, the second injection day, a week after injection, a month after injection and after three months. Results: The mean values of the intraocular pressure mean increased from the second day of injection in the study groups (B) and (B+TA) and the mean of the IOP values before injection (13.34-13.31 mmHg) respectively, and the IOP values showed the maximum in both groups after a week of the injection (17.81-17.31 mmHg) then began to decrease after a month and three months later to (17.34-17.06mmHg) and (17.6-16.75mmHg) mercury respectively, but they remained higher than they were before the injection, and the number of injections had no effect on intraocular pressure. Conclusion: intravitreal injections with both bevacizumab alone or in combination with triamcinolone acetonide resulted in a rise in intraocular pressure, and differences in pressure values were statistically significant within the same group during the studied time periods but were not statistically significant between the two groups, and the number of injections had no effect on intraocular pressure.
VL  - 6
IS  - 2
ER  -

Copy | Download

Author Information

Nour Yasser Barakat

Ophthalmology Department, Faculty of Medicine of Tishreen University, Lattakia, Syria
Yusuf Suleiman

Ophthalmology Department, Faculty of Medicine of Tishreen University, Lattakia, Syria
Kahtan Jalloul

Ophthalmology Department, Faculty of Medicine of Tishreen University, Lattakia, Syria

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Nour Yasser Barakat, Yusuf Suleiman, Kahtan Jalloul. (2020). Intraocular Pressure Changes After Intravitreal Bevacizumab Injection Alone or Combination of Bevacizumab and Triamcinolone Acetonide. International Journal of Homeopathy & Natural Medicines, 6(2), 6-14. https://doi.org/10.11648/j.ijhnm.20200602.11

Copy | Download

ACS Style

Nour Yasser Barakat; Yusuf Suleiman; Kahtan Jalloul. Intraocular Pressure Changes After Intravitreal Bevacizumab Injection Alone or Combination of Bevacizumab and Triamcinolone Acetonide. Int. J. Homeopathy Nat. Med. 2020, 6(2), 6-14. doi: 10.11648/j.ijhnm.20200602.11

Copy | Download

AMA Style

Nour Yasser Barakat, Yusuf Suleiman, Kahtan Jalloul. Intraocular Pressure Changes After Intravitreal Bevacizumab Injection Alone or Combination of Bevacizumab and Triamcinolone Acetonide. Int J Homeopathy Nat Med. 2020;6(2):6-14. doi: 10.11648/j.ijhnm.20200602.11

Copy | Download

@article{10.11648/j.ijhnm.20200602.11,
  author = {Nour Yasser Barakat and Yusuf Suleiman and Kahtan Jalloul},
  title = {Intraocular Pressure Changes After Intravitreal Bevacizumab Injection Alone or Combination of Bevacizumab and Triamcinolone Acetonide},
  journal = {International Journal of Homeopathy & Natural Medicines},
  volume = {6},
  number = {2},
  pages = {6-14},
  doi = {10.11648/j.ijhnm.20200602.11},
  url = {https://doi.org/10.11648/j.ijhnm.20200602.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijhnm.20200602.11},
  abstract = {Aim: To evaluate intraocular pressure changes after intravitreal injection of Bevacizumab alone or in combination with Triamcinolone Acetonide. Method: Our study included 63 eyes from the ophthalmology department at Tishreen University Hospital who had vascular retinal diseases. The patients were divided into two groups according to the indication of injection. The first group was injected with bevacizumab (B) at a concentration of 2.5mg / 0.1 ml and the second group was injected with the combination treatment of Triamcinolone Acetonide at a concentration of 2mg / 0.05ml with bevacizumab (B+TA) at a concentration of 1.25mg/ 0.05ml. Intraocular pressure was monitored on the Goldman applanation tonometry and values were recorded as follows: before injection, the second injection day, a week after injection, a month after injection and after three months. Results: The mean values of the intraocular pressure mean increased from the second day of injection in the study groups (B) and (B+TA) and the mean of the IOP values before injection (13.34-13.31 mmHg) respectively, and the IOP values showed the maximum in both groups after a week of the injection (17.81-17.31 mmHg) then began to decrease after a month and three months later to (17.34-17.06mmHg) and (17.6-16.75mmHg) mercury respectively, but they remained higher than they were before the injection, and the number of injections had no effect on intraocular pressure. Conclusion: intravitreal injections with both bevacizumab alone or in combination with triamcinolone acetonide resulted in a rise in intraocular pressure, and differences in pressure values were statistically significant within the same group during the studied time periods but were not statistically significant between the two groups, and the number of injections had no effect on intraocular pressure.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Intraocular Pressure Changes After Intravitreal Bevacizumab Injection Alone or Combination of Bevacizumab and Triamcinolone Acetonide
AU  - Nour Yasser Barakat
AU  - Yusuf Suleiman
AU  - Kahtan Jalloul
Y1  - 2020/12/11
PY  - 2020
N1  - https://doi.org/10.11648/j.ijhnm.20200602.11
DO  - 10.11648/j.ijhnm.20200602.11
T2  - International Journal of Homeopathy & Natural Medicines
JF  - International Journal of Homeopathy & Natural Medicines
JO  - International Journal of Homeopathy & Natural Medicines
SP  - 6
EP  - 14
PB  - Science Publishing Group
SN  - 2472-2316
UR  - https://doi.org/10.11648/j.ijhnm.20200602.11
AB  - Aim: To evaluate intraocular pressure changes after intravitreal injection of Bevacizumab alone or in combination with Triamcinolone Acetonide. Method: Our study included 63 eyes from the ophthalmology department at Tishreen University Hospital who had vascular retinal diseases. The patients were divided into two groups according to the indication of injection. The first group was injected with bevacizumab (B) at a concentration of 2.5mg / 0.1 ml and the second group was injected with the combination treatment of Triamcinolone Acetonide at a concentration of 2mg / 0.05ml with bevacizumab (B+TA) at a concentration of 1.25mg/ 0.05ml. Intraocular pressure was monitored on the Goldman applanation tonometry and values were recorded as follows: before injection, the second injection day, a week after injection, a month after injection and after three months. Results: The mean values of the intraocular pressure mean increased from the second day of injection in the study groups (B) and (B+TA) and the mean of the IOP values before injection (13.34-13.31 mmHg) respectively, and the IOP values showed the maximum in both groups after a week of the injection (17.81-17.31 mmHg) then began to decrease after a month and three months later to (17.34-17.06mmHg) and (17.6-16.75mmHg) mercury respectively, but they remained higher than they were before the injection, and the number of injections had no effect on intraocular pressure. Conclusion: intravitreal injections with both bevacizumab alone or in combination with triamcinolone acetonide resulted in a rise in intraocular pressure, and differences in pressure values were statistically significant within the same group during the studied time periods but were not statistically significant between the two groups, and the number of injections had no effect on intraocular pressure.
VL  - 6
IS  - 2
ER  -

Copy | Download