Morphometric changes in optic nerve head parameters in ocular hypertension induced by intravitreal administration of angiogenesis inhibitors
https://doi.org/10.53432/2078-4104-2024-23-4-11-20
Abstract
PURPOSE. To compare the changes in morphometric parameters of the optic nerve head (ONH) following intravitreal injections (IVI) of aflibercept in patients with natural and artificial lenses.
METHODS. The study included 60 patients, divided into two groups: the control group, consisting of 30 patients with natural lenses, and the main group, consisting of 30 patients with intraocular lenses. All patients underwent three aflibercept IVIs at 4-week intervals, followed by a treat-and-extend regimen for one year. Intraocular pressure (IOP) was measured with the iCare Pro tonometer before IVI, and 1 minute and 60 minutes after IVI. All patients underwent optical coherence tomography (OCT) of the ONH, using radial (star-shaped) scans. Horizontal slices of the ONH were analyzed.
RESULTS. By the end of the observation period, both groups had received a comparable number of IVIs. The average IOP increase 1 minute after IVI exceeded 15 mm Hg compared to baseline in both groups. In the control group, one year after treatment, an increase in optic disc cup width was observed, with the median increasing by 15 μm (p<0.001). The median cup depth increased by 8 μm (p<0.001). In the main group, cup width also increased, with a median increase of 6 μm (p<0.001), and cup depth increased by 4 μm (p<0.001). These changes were statistically more pronounced in the control group compared to the main group. In both groups, the Bruch’s membrane opening diameter and the distance to the anterior surface of the lamina cribrosa did not significantly change throughout the observation period.
CONCLUSION. A series of acute IOP elevations due to repeated IVIs over the course of a year is associated with an increase in the width and depth of optic disc cup, which is more pronounced in patients with natural lenses.
About the Authors
Yu. S. Andreeva
Krasnov Research Institute of Eye Diseases
Russian Federation
Russian Federation
postgraduate student at the Department of Retinal and Optic Nerve Pathology
11A Rossolimo St., Moscow, 119021
L. Alharki
Krasnov Research Institute of Eye Diseases
Russian Federation
Russian Federation
Cand. Sci. (Med.), Senior Researcher at the Department of Innovative Vitreoretinal Technologies, Associate Professor at the Academic Department of Ophthalmology
11A Rossolimo St., Moscow, 119021
M. V. Budzinskaya
Krasnov Research Institute of Eye Diseases
Russian Federation
Russian Federation
Dr. Sci. (Med.), Chief Researcher at the Department of Retinal and Optic Nerve Pathology, Professor at the Academic Department of Ophthalmology
11A Rossolimo St., Moscow, 119021
References
1. CATT Research Group, Martin DF, Maguire MG, Ying GS, Grunwald JE, Fine SL, et al. Ranibizumab and bevacizumab for neovascular agerelated macular degeneration. N Engl J Med 2011; 364:1897-908. https://doi.org/10.1056/NEJMoa1102673
2. Petrachkov DV, Budzinskaya MV, Pavlov VG, Durzhinskaya MH, Khalatyan AS. Neurodegenerative biomarkers of the response to diabetic macular edema treatment. Russian Annals of Ophthalmology 2020; 136(4):201206. https://doi.org/10.17116/oftalma2020136042201
3. Budzinskaya MV, Plyukhova AA, Afanasyeva MA, Gorkavenko FV. New criteria of effectiveness of anti-VEGF therapy in exudative agerelated macular degeneration. Russian Annals of Ophthalmology 2022; 138(4):58-66. https://doi.org/10.17116/oftalma202213804158
4. Fayzrakhmanov R.R. Anti-VEGF therapy of neovascular age-related macular degeneration: from randomized trials to routine clinical practice. Russian Ophthalmological Journal 2019; 12(2):97-105. https://doi.org/10.21516/2072-0076-2019-12-2-97-105
5. Wykoff C.C., Ou W.C., Brown D.M., et al. Randomized trial of treatand-extend versus monthly dosing for neovascular age-related macular degeneration: 2-year results of the TREX-AMD study. Ophthalmol Retina 2017; 1(4):314-321. https://doi.org/10.1016/j.oret.2016.12.004
6. Kim JE, Mantravadi AV, Hur EY, Covert DJ. Short-term intraocular pressure changes immediately after intravitreal injections of antivascular endothelial growth factor agents. Am J Ophthalmol 2008; 146:930-934.e931. https://doi.org/10.1016/j.ajo.2008.07.007
7. Eadie BD, Etminan M, Carleton BC, et al. Association of repeated intravitreous bevacizumab injections with risk for glaucoma surgery. JAMA Ophthalmol 2017; 135:363-368. https://doi.org/10.1001/jamaophthalmol.2017.0059.
8. Bubnova I., Yulova A. Optic nerve head changes with acute IOP elevation after intravitreal injections. National journal glaucoma 2016; 15(2):54-60.
9. Jiang, R., Xu, L., Liu, X., Chen, J. D., Jonas, J. B., & Wang, Y. X. Optic Nerve Head Changes after Short-Term Intraocular Pressure Elevation in Acute Primary Angle-Closure Suspects. Ophthalmology 2015; 122(4):730-737. https://doi.org/10.1016/j.ophtha.2014.11.008
10. Strakhov V.V., Korchagin N.V., Popova A.A. The biomechanical aspect of the pathological optic disc cupping development in glaucoma. National journal glaucoma 2015; 14(3):58-71.
11. Alaghband P, Beltran-Agulló L, Galvis E, Overby D, Lim K. Effect of phacoemulsification on facility of outflow. British Journal of Ophthalmology 2018; 102(11):1520-1526. https://doi.org/10.1136/bjophthalmol-2017-311548
12. Nolan P.; See L.; Friedman, David S.; Chan, Yiong-Huak. Changes in Angle Configuration After Phacoemulsification Measured by Anterior Segment Optical Coherence Tomography. Journal of Glaucoma 2008; 17(6):455-459. https://doi.org/10.1097/IJG.0b013e3181650f31
13. Kerimoglu, H., Ozturk, B. T., Bozkurt, B., Okka, M., & Okudan, S. Does lens status affect the course of early intraocular pressure and anterior chamber changes after intravitreal injection? Acta Ophthalmologica 2011; 89(2):138-142. https://doi.org/10.1111/j.1755-3768.2009.01656.x
14. Atchison E, Wood K, Mattox C, Barry C, Lum F, MacCumber M. The real-world effect of intravitreous anti–vascular endothelial growth factor drugs on intraocular pressure: an analysis using the IRIS registry. Ophthalmology 2018; 125:676-682. https://doi.org/10.1016/j.ophtha.2017.11.027
15. El Chehab H, Agard E, Russo A, Boujnah Y, Dot C. Intraocular Pressure Spikes after Aflibercept Intravitreal Injections. Ophthalmologica 2016; 236:43-47. https://doi.org/10.1159/000446878
16. Bubnova I A, Kurguzova A G. Changes in intraocular pressure after intravitreal injections. Russian Annals of Ophthalmology 2018; 134(4): 47-51. https://doi.org/10.17116/oftalma201813404147
17. Singh, K., Cheema, A., Kung, J., & Choi, D. Cataract surgery in the glaucoma patient. Middle East African Journal of Ophthalmology 2015; 22(1):10-17. https://doi.org/10.4103/0974-9233.148343
18. Poley B.J., Lindstrom R.L. Longterm effects of phacoemulsification with intraocular lens implantation in normotensive and ocular hypertensive eyes. J Cataract Refract Surg 2008; 34(5):735-742. https://doi.org/10.1016/j.jcrs.2007.12.045
19. Burgoyne C.F., Downs J.C., Bellezza A.J. at al. The optic nerve head as biomechanical structure: a new paradigm for understanding the role of IOP-related stress and strain in the pathophysiology of glaucomatous optic nerve head damage. Prog Retin Eye Res 2005; 24(1):19-73. https://doi.org/10.1016/j.preteyeres.2004.06.001
Review
For citations:
Andreeva Yu.S., Alharki L., Budzinskaya M.V. Morphometric changes in optic nerve head parameters in ocular hypertension induced by intravitreal administration of angiogenesis inhibitors. National Journal glaucoma. 2024;23(4):11-20. (In Russ.) https://doi.org/10.53432/2078-4104-2024-23-4-11-20
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