Effect of Intravitreal Injections on Retinal Imaging Metrics in Glaucomatous and Non-Glaucomatous Eyes
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RETINA (R GOLDHARDT, SECTION EDITOR)
Effect of Intravitreal Injections on Retinal Imaging Metrics in Glaucomatous and Non-Glaucomatous Eyes Ronaldo Nuesi 1,2 & Swarup S. Swaminathan 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020, corrected publication 2020
Abstract Purpose of Review To summarize the available literature on retinal imaging metrics in the context of intravitreal injections in glaucomatous and non-glaucomatous eyes. Recent Findings The retinal nerve fiber layer (RNFL) in injected non-glaucomatous eyes appears to thin at a similar rate to uninjected fellow eyes. A total of four studies evaluating RNFL thinning in injected glaucomatous eyes yielded mixed results, with more recent longitudinal investigations suggesting a potential association. The ganglion cell-inner plexiform layer is also being studied as a potential endpoint in both glaucomatous and non-glaucomatous eyes following intravitreal injections. Summary There appears to be minimal association between intravitreal injections and RNFL thinning among non-glaucomatous eyes. However, in glaucomatous eyes, fewer studies have been published, and results have varied due to challenges in study design. Additional prospective studies with longer follow-up periods are warranted. Keywords Glaucoma . Intravitreal injections . Ocular hypertension . Retinal nerve fiber layer . Ganglion cell layer . Ganglion cell-inner plexiform layer . Optic nerve
Introduction Glaucoma is the most common cause of irreversible blindness in the world [1]. Elevated intraocular pressure (IOP) is a key risk factor in glaucomatous optic neuropathy. Wet age-related macular degeneration (AMD), diabetic macular edema (DME), and retinal vein occlusion (RVO) are retinal diseases that impact central visual acuity and are typically treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections [2, 3]. Anti-VEGF injections have become one of the most common procedures performed in medicine, with an
This article is part of the Topical Collection on Retina * Swarup S. Swaminathan [email protected] Ronaldo Nuesi [email protected] 1
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St, Miami, FL 33136, USA
2
Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
estimated 5.9 million injections being performed in the USA alone in 2016 [4]. The safety profile of intravitreal injections in glaucoma patients has been evaluated closely [5]. Studies demonstrated a transient but sizable effect of intravitreal injections on IOP, which led to concerns regarding potential irreversible effects of post-injection IOP elevations [6–10]. Many studies have assessed whether these recurrent IOP spikes may damage retinal structures and whether intravitreal injections may accelerate the progression of glaucoma [11]. In this review, we aim to summarize the available literature regarding the impact of intravitreal injections on the retinal nerve fi
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