Acute rises in IOP that occur with anti-VEGF injections is a real phenomenon, but it is transient and may not necessarily warrant any intervention for many patients, according to Matthew Schlenker MD, MSc.
Anti-VEGF injections may be associated with acute IOP spikes and chronic IOP rise in patients, and these increases in IOP need to be acknowledged and managed, according to Matthew Schlenker MD, MSc.
Dr. Schlenker is an assistant professor and University of Toronto, glaucoma, cataract, and anterior segment surgeon, Trillium Health Partners, Kensington Eye Institute, and Toronto Western Hospital, Toronto, Canada.
Speaking at the annual Sally Letson Symposium, Dr. Schlenker discussed whether anti-VEGF injections are treating or causing glaucoma, Dr. Schlenker described instances where VEGF inhibitors have a role and where IOP elevations may be a concern that need to be addressed.
“When you see neovascularization of the iris, these eyes need anti-VEGF (injections) as soon as possible,” said Dr. Schlenker. “This is an opportunity to prevent peripheral anterior synechiae (PAS), and we all know the outcomes are guarded once we have 360° of PAS.”
With respect to wound modulation in filtering surgery, it is complicated to decide whether to use subconjunctival anti-VEGF injections, according to Dr. Schlenker.
“There are plausible mechanisms of action,” he said. “There are some in vitro studies that are promising, and there have been animal studies that are promising. However, the clinical studies have yielded mixed results.”
Matthew Schlenker, MD, MSc, FRCPC
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This article was adapted from Dr. Schlenker’s presentation at the 51st Sally Letson Symposium in Ottawa, Ontario, Canada. Dr. Schlenker has no financial disclosures related to this content.