Glaucoma progression in patients receiving intravitreal anti-VEGF treatment for neovascular age-related macular degeneration

Inka Pirinen, Sanna Leinonen, Mika Helminen, Pekko Hujanen, Anu Vaajanen, Anja Tuulonen, Hannele Uusitalo-Järvinen

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Purpose: The purpose of this study was to investigate how often glaucoma and neovascular age-related macular degeneration (nAMD) occur in the same patient and to evaluate whether glaucoma progression is faster in eyes treated with intravitreal anti-VEGF medications for nAMD. Methods: This single-centre retrospective real-world data (RWD) consists of medical records of 6314 glaucoma and 2166 nAMD patients treated in 2008–2017 in Tays Eye Centre, Finland. To study glaucoma progression, changes in visual fields (mean deviation [MD], dB/year), IOP (mmHg/year) and fundus photographs (progression, yes/no) were compared in glaucoma eyes with and without anti-VEGF treatment for nAMD and ≥1 year follow-up. Results: During the 10-year period, 147 patients with glaucoma received intravitreal anti-VEGF treatment for nAMD corresponding to 2% of glaucoma and 7% of nAMD patients. The mean change in MD was −0.70 dB/year (SD 1.8) vs. −0.27 dB/year (SD 1.7) (p = 0.027) in glaucoma eyes with (n = 37) and without (n = 4304) anti-VEGF injections, respectively. In patients with bilateral glaucoma and unilateral nAMD treated with anti-VEGF injections (n = 20), MD declined at −0.62 dB/year (SD 1.9) vs 0.33 dB/year (SD 1.5) (p = 0.654), and glaucoma progression was detected in 14/20 vs 10/20 (p = 0.219) fundus photographs in eyes with anti-VEGF treatment compared with their untreated fellow eyes. Conclusion: nAMD and glaucoma were found co-existing in the same eye at rates that were similar to the age-corrected prevalence of the two diseases in the general population. Our results suggest that intravitreal anti-VEGF treatment for nAMD may accelerate glaucoma progression.

Original languageEnglish
Pages (from-to)261-265
Number of pages5
JournalActa Ophthalmologica
Volume101
Issue number3
Early online date2022
DOIs
Publication statusPublished - 2023
Publication typeA1 Journal article-refereed

Keywords

  • AMD
  • anti-VEGF injections
  • glaucoma progression
  • real-world data

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Ophthalmology

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