J Korean Ophthalmol Soc > Volume 55(5); 2014 > Article
Journal of the Korean Ophthalmological Society 2014;55(5):693-701.
DOI: https://doi.org/10.3341/jkos.2014.55.5.693    Published online May 15, 2014.
Changes in the Retinal Nerve Fiber Layer after Intravitreal Injections of Bevacizumab in Glaucoma Patients.
Chang Hyun Park, Kee Il Lee, Hae Young Park, Jin Hae Lee, In Tae Kim, Chan Kee Park
Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. ckpark@catholic.ac.kr
녹내장 환자에서 유리체강 내 베바시주맙 주사가 망막신경섬유층에 미치는 영향
박창현⋅이기일⋅박혜영⋅이진해⋅김인태⋅박찬기
Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
Abstract
PURPOSE
To examine retinal nerve fiber layer (RNFL) changes after intravitreal injection of bevacizumab in patients with or without underlying glaucoma. METHODS: A total of 104 eyes of 104 patients with retinal disease undergoing intravitreal injection of bevacizumab were prospectively investigated. Bevacizumab injections (1.25/0.05 mg/mL) were performed using a standardized technique. In the patient who had pretreatment with intraocular pressure (IOP)-lowering medication, 1 drop of brimonidine was instilled 30 minutes before the injection. Before and after the intravitreal injections, the patients were monitored for IOP and evaluated with optical coherence tomography using Stratus at least 3 months after the injection. RESULTS: Thirty minutes after injection, 6.4% of patients had an IOP over 30 mm Hg in the non-pretreatment group while no patient had an IOP over 30 mm Hg in the pretreatment group. In eyes with only retinal diseases, the RNFL thickness did not change significantly after the injection regardless of pretreatment, whereas in eyes with underlying glaucomatous damage and no pretreatment, significant decrease in RNFL thickness was observed at the superior (p = 0.036) and temporal (p = 0.048) sectors of the optic nerve head without pretreatment. CONCLUSIONS: Intravitreal injection of bevacizumab did not typically cause significant changes in RNFL thickness; however, in eyes with underlying glaucoma without pretreatment, a significant decrease in RNFL thickness was observed in the superior and temporal sectors of the optic nerve head. Therefore, applying IOP-lowering pretreatment medication before intravitreal injection of bevacizumab is required for protection of RNFL in glaucoma patients.
Key Words: Bevacizumab;Intraocular pressure;Retinal nerve fiber layer thickness


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