PMID- 38026596 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231201 IS - 1177-5467 (Print) IS - 1177-5483 (Electronic) IS - 1177-5467 (Linking) VI - 17 DP - 2023 TI - Effect of Repeated Intravitreal Injections in Glaucoma Spectrum Diseases. PG - 3613-3627 LID - 10.2147/OPTH.S441500 [doi] AB - PURPOSE: To evaluate whether repeated intravitreal injections (IVI) with an anti-vascular endothelial growth factor (anti-VEGF) agent are associated with glaucomatous progression in eyes with glaucoma spectrum diseases (GSD). METHODS: Single-center, retrospective, longitudinal study of patients with bilateral and similar GSD who: (1) received >/=8 IVI in only one eye during the study period; (2) had >/=2 retinal nerve fiber layer thickness (RNFL) measurements obtained by spectral-domain optical coherence tomography (SD-OCT) at least 12 months apart. The primary outcome was the absolute RNFL thickness change, comparing injected and fellow uninjected eyes. Linear mixed effects models were constructed, including a multivariable model. RESULTS: Sixty-eight eyes from 34 patients were included, 34 injected and 34 fellow uninjected eyes. Average baseline age was 67.68+/-21.77 years with a follow-up of 3.66+/-1.89 years and 25.12+/-14.49 IVI. RNFL thickness decreased significantly from 80.92+/-15.78 to 77.20+/-17.35 mum (p<0.001; -1.18+/-1.93 mum/year) in injected eyes and from 79.95+/-17.91 to 76.61+/-17.97 mum (p<0.001; -1.07+/-0.98 mum/year) in uninjected eyes. In a multivariable linear mixed model of injected eyes, only higher baseline RNFL thickness (p < 0.001) significantly predicted higher absolute RNFL thickness loss. Neither absolute RNFL thickness variation (p=0.716) nor RNFL rate (p=0.779) was significantly different between paired injected and uninjected eyes. Absolute IOP variation was not significantly different between groups (16.62+/-4.77 to 15.09+/-4.34 mmHg in injected eyes and 17.68+/-5.01 to 14.50+/-3.39 mmHg in fellow uninjected eyes; p=0.248). The proportion of eyes receiving glaucoma medical treatment increased significantly in both groups (55.9% to 76.5% in injected eyes; p=0.039; 58.8% to 76.5% in uninjected eyes; p = 0.031). The number of glaucoma medications also increased significantly in both groups (1.03+/-1.11 to 1.59+/-1.18 glaucoma medications in injected eyes; p=0.003; 1.09+/-1.11 to 1.56+/-1.19 glaucoma medications in uninjected eyes; p=0.003). CONCLUSION: Repeated IVI do not seem to accelerate glaucomatous progression. Future studies with a longer follow-up are needed. CI - (c) 2023 Vilares-Morgado et al. FAU - Vilares-Morgado, Rodrigo AU - Vilares-Morgado R AUID- ORCID: 0000-0003-3325-2194 AD - Department of Ophthalmology, Centro Hospitalar e Universitario de Sao Joao, Porto, Portugal. AD - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal. FAU - Correia, Vera AU - Correia V AD - Faculty of Medicine, University of Porto, Porto, Portugal. FAU - Ferreira, Ana Margarida AU - Ferreira AM AD - Department of Ophthalmology, Centro Hospitalar e Universitario de Sao Joao, Porto, Portugal. FAU - Alves, Flavio AU - Alves F AD - Department of Ophthalmology, Centro Hospitalar e Universitario de Sao Joao, Porto, Portugal. FAU - Melo, Antonio Benevides AU - Melo AB AD - Department of Ophthalmology, Centro Hospitalar e Universitario de Sao Joao, Porto, Portugal. AD - Faculty of Medicine, University of Porto, Porto, Portugal. FAU - Estrela-Silva, Sergio AU - Estrela-Silva S AUID- ORCID: 0000-0002-7415-813X AD - Department of Ophthalmology, Centro Hospitalar e Universitario de Sao Joao, Porto, Portugal. AD - Faculty of Medicine, University of Porto, Porto, Portugal. FAU - Araujo, Joana AU - Araujo J AD - Department of Ophthalmology, Centro Hospitalar e Universitario de Sao Joao, Porto, Portugal. AD - Faculty of Medicine, University of Porto, Porto, Portugal. FAU - Tavares-Ferreira, Joao AU - Tavares-Ferreira J AUID- ORCID: 0000-0002-5283-2939 AD - Department of Ophthalmology, Centro Hospitalar e Universitario de Sao Joao, Porto, Portugal. AD - Faculty of Medicine, University of Porto, Porto, Portugal. FAU - Silva, Marta AU - Silva M AD - Department of Ophthalmology, Centro Hospitalar e Universitario de Sao Joao, Porto, Portugal. FAU - Rocha-Sousa, Amandio AU - Rocha-Sousa A AD - Department of Ophthalmology, Centro Hospitalar e Universitario de Sao Joao, Porto, Portugal. AD - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal. FAU - Carneiro, Angela AU - Carneiro A AD - Department of Ophthalmology, Centro Hospitalar e Universitario de Sao Joao, Porto, Portugal. AD - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal. FAU - Barbosa-Breda, Joao AU - Barbosa-Breda J AUID- ORCID: 0000-0001-7816-816X AD - Department of Ophthalmology, Centro Hospitalar e Universitario de Sao Joao, Porto, Portugal. AD - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal. AD - KULeuven, Research Group Ophthalmology, Department of Neurosciences, Leuven, Belgium. LA - eng PT - Journal Article DEP - 20231122 PL - New Zealand TA - Clin Ophthalmol JT - Clinical ophthalmology (Auckland, N.Z.) JID - 101321512 PMC - PMC10676727 OTO - NOTNLM OT - glaucoma OT - intravitreal injections OT - optical coherence tomography OT - progression OT - retinal nerve fiber layer thickness COIS- The authors have no conflicts of interest to declare. EDAT- 2023/11/29 18:42 MHDA- 2023/11/29 18:43 PMCR- 2023/11/22 CRDT- 2023/11/29 16:55 PHST- 2023/10/16 00:00 [received] PHST- 2023/11/07 00:00 [accepted] PHST- 2023/11/29 18:43 [medline] PHST- 2023/11/29 18:42 [pubmed] PHST- 2023/11/29 16:55 [entrez] PHST- 2023/11/22 00:00 [pmc-release] AID - 441500 [pii] AID - 10.2147/OPTH.S441500 [doi] PST - epublish SO - Clin Ophthalmol. 2023 Nov 22;17:3613-3627. doi: 10.2147/OPTH.S441500. eCollection 2023.