• CHAKAR TAJWIDI Helper Eye Hospital Quetta, Baluchistan, Department of Health Government of Baluchistan, Pakistan
  • SHIASTA TABASSUM Helper Eye Hospital Quetta, Baluchistan, Department of Health Government of Baluchistan, Pakistan
  • RAHMAM GUL Department of Health Government of Baluchistan, Pakistan, Institute of Public Health Quetta



Anti-VEGF, Intraocular pressure, Applanation tonometer


Objective: The objective of the study is to assess the frequency of raised IOP after intravitreal injection of Anti VEGF by using an applanation tonometer.

Methods: Each patients who fulfil the presence criteria were nominated by the researcher through ‘the outpatient department (OPD) of ophthalmology, Jinnah Post Graduate Medical Center. Performa was filled. Aim and process of study was explained to all patients. Conversant consent was reserved. Model ocular inspection, including IOP was done.

By using either a 30-or 32-gauge needle, 1.25 ml bevacizumab (Avastin) were administered by the researcher under the direct supervision of consultant. Patients were consistently sterilely prepped, that was comprised incerted of topical antibiotic and anesthetic drops, supplement of a lid speculum. Later pointing the injection place on the sclera with a caliper calculating 3.0 to 3.5 mm after limbus, conjunctiva was expatriate somewhat through a sterile cotton-tipped applicator immediately earlier ingoing the eye by a needle. Later injection, place was occluded provisionally it was amended through a sterile cotton-tipped applicator while the needle remained inhibited from the eye. Since the needle was inhibited, a drop of anesthetic was employed on the cornea and IOP was measured. Then next IOP interpretation was measured later 1day of intravitreal Avastin.

All pressures were measured using the applantation tonometry. IOPs were measured earlier intravitreal Avastin "baseline IOP" and instantly following injection "T0" and 1day next injection.

Results: 235 Patients exactly nominated for the research study. Intravitreal Injection, Bevacizumab was applied in 235 Eyes of overstated 235 patients. Elsewhere of the 235 patients, 133 males and 102 females, Their ages ranged from 30-70 y (mean 52.02 y. The most shared sign intravitreal with bevacizumab, diabetic retinopathy observed in 114 (48.5%) patients, indicated by exudative ARMD in 70 (29.7%) patients, BRVO in 12 (5%) patients, Myopic CNV23(9.7) with CRVO observed in 11 (4.6%) patients, Eale’s sickness in 2(0.85%) patients even as Idiopathic CNV was observed in only 3 (1%) patient. Of the 235 patients, 118 (50.2%) patients with right eye suffered, 117(49.7%) patients with left eye suffered. After 24 h of intravitreal Bevacizumab Raised IOP was observed in only 3 (1.28) patient and 232(98.2) patient IOP was in the normal range. According to our study, the result of stratification with respect to age, side of the eye and gender is not significant as p-value for age (0.838), gender (0.723) and side of the eye (0.556), respectively.

Conclusion: In our study, frequency of raised IOP after anti VEGF were found 3(1.28) patient out of 232 (98.2). Anti-VEGF treatment is the foundation for the management of numerous retinal illnesses. Notwithstanding its capable effectiveness in uncertain the sickness and refining, vision for the patients, intravitreal injection of anti-VEGF products may be related with overwhelming problems. To diminish the risk cautious care to the injection method and suitable post-injection observing are essential.


Download data is not yet available.


Marano RJ, Rakoczy PE. Treatments for choroidal and retinal neovascularization: a focus on oligonucleotide therapy and delivery for the regulation of gene function. Clin Exp Ophthalmol. 2005;33(1):81-9. doi: 10.1111/j.1442-9071.2005.00952.x, PMID 15670087.

Adamis AP, Shima DT. The role of vascular endothelial growth factor in ocular health and disease. Retina. 2005;25(2):111-8. doi: 10.1097/00006982-200502000-00001, PMID 15689799.

Ferrara N, Gerber HP, LeCouter J. The biology of VEGF and its receptors. Nat Med. 2003;9(6):669-76. doi: 10.1038/nm0603-669, PMID 12778165.

Otani A, Takagi H, Oh H, Koyama S, Ogura Y, Matumura M, Honda Y. Vascular endothelial growth factor family and receptor expression in human choroidal neovascular membranes. Microvasc Res. 2002;64(1):162-9. doi: 10.1006/mvre.2002.2407, PMID 12074642.

Rosenfeld PJ, Moshfeghi AA, Puliafito CA. Optical coherence tomography findings after intravitreal injection of bevacizumab (Avastin) for neovascular age-related macular degeneration. Ophthalmic Surg Lasers Imaging. 2005;36(4):331-35. doi: 10.3928/1542-8877-20050701-14, PMID 16156152.

Iturralde D, Spaide RF, Meyerle CB, Klancnik JM, Yannuzzi LA, Fisher YL, Sorenson J, Slakter JS, Freund KB, Cooney M, Fine HF. Intravitreal bevacizumab (Avastin) treatment of macular edema in central retinal vein occlusion: a short-term study. Retina. 2006;26(3):279-84. doi: 10.1097/00006982-200603000-00005, PMID 16508427.

Avery RL, Pearlman J, Pieramici DJ, Rabena MD, Castellarin AA, Nasir MA, Giust MJ, Wendel R, Patel A. Intravitreal bevacizumab(Avastin) in the treatment of proliferative diabetic retinopathy. Ophthalmology. 2006;113(10):1695.e1-15. doi: 10.1016/j.ophtha.2006.05.064, PMID 17011951.

Oshima Y, Sakaguchi H, Gomi F, Tano Y. Regression of iris neovascularization after intravitreal injection of bevacizumab in patients with proliferative diabetic retinopathy. Am J Ophthalmol. 2006;142(1):155-8. doi: 10.1016/ j.ajo.2006.02.015, PMID 16815267.

Sakaguchi H, Ikuno Y, Gomi F, Kamei M, Sawa M, Tsujikawa M, Oshima Y, Kusaka S, Tano Y. Intravitreal injection of bevacizumab for choroidal neovascularisation associated with pathological myopia. Br J Ophthalmol. 2007;91(2):161-65. doi: 10.1136/bjo.2006.099887, PMID 16914470.

Gomi F, Nishida K, Oshima Y, Sakaguchi H, Sawa M, Tsujikawa M, Tano Y. Intravitreal bevacizumab for idiopathic choroidal neovascularization after the previous injection with posterior subtenon triamcinolone. Am J Ophthalmol. 2007;143(3):507-10. doi: 10.1016/j.ajo.2006.10.050, PMID 17317397.

Falkenstein IA, Cheng L, Freeman WR. Changes of intraocular pressure after intravitreal injection of bevacizumab (avastin). Retina. 2007;27(8):1044-47. doi: 10.1097/ IAE.0b013e3180592ba6, PMID 18040242.

Gismondi M, Salati C, Salvetat ML, Zeppieri M, Brusini P. Short-term effect of intravitreal injection of ranibizumab (Lucentis) on intraocular pressure. J Glaucoma. 2009;18(9):658-61. doi: 10.1097/IJG.0b013e31819c4893, PMID 20010243.

Sharei V, Höhn F, Köhler T, Hattenbach LO, Mirshahi A. Course of intraocular pressure after intravitreal injection of 0.05 mL ranibizumab (Lucentis). Eur J Ophthalmol. 2010;20(1):174-79. doi: 10.1177/112067211002000124, PMID 19927267.

Kim JE, Mantravadi AV, Hur EY, Covert DJ. Short-term intraocular pressure changes immediately after intravitreal injections of anti-vascular endothelial growth factor agents. Am J Ophthalmol. 2008;146(6):930-4.e1. doi: 10.1016/j.ajo.2008.07.007, PMID 18775528.

Hollands H, Wong J, Bruen R, Campbell RJ, Sharma S, Gale J. Short-term intraocular pressure changes after intravitreal injection of bevacizumab. Can J Ophthalmol. 2007;42(6):807-11. doi: 10.3129/i07-172, PMID 18026202.

Pe’er J, Folberg R, Itin A, Gnessin H, Hemo I, Keshet E. Vascular endothelial growth factor upregulation in human central retinal vein occlusion. Ophthalmology. 1998 Mar;105(3):412-6. doi: 10.1016/S0161-6420(98)93020-2, PMID 9499769.

Marshall J. The role of bevacizumab as first-line therapy for colon cancer. Semin Oncol. 2005 Dec;32(6):Suppl 9:S43-7. doi: 10.1053/j.seminoncol.2005.06.003, PMID 16399431.

Arevalo JF, Garcia-Amaris RA, Roca JA, Sanchez JG, Wu L, Berrocal MH, Maia M, Pan-American Collaborative Retina Study Group. Primary intravitreal bevacizumab for the management of pseudophakic cystoid macular edema: pilot study of the Pan American Collaborative retina Study Group. J Cataract Refract Surg. 2007 Dec;33(12):2098-105. doi: 10.1016/j.jcrs.2007.07.046, PMID 18053911.

Honda S, Hirabayashi H, Tsukahara Y, Negi A. Acute contraction of the proliferative membrane after intravitreal injection of bevacizumab for advanced retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol. 2008 Mar 5 [Epub ahead of print];246(7):1061-3. doi: 10.1007/s00417-008-0786-7, PMID 18320201.

Finger PT. Radiation retinopathy is treatable with anti-vascular endothelial growth factor bevacizumab (Avastin). Int J Radiat Oncol Biol Phys. 2008 Mar 15;70(4):974-7. doi: 10.1016/j.ijrobp.2007.11.045, PMID 18313522.

Kahook MY, Ammar DA. In vitro effects of antivascular endothelial growth factors on cultured human trabecular meshwork cells. J Glaucoma. 2010;19(7):437-41. doi: 10.1097/IJG.0b013e3181ca74de, PMID 20164801.



How to Cite

TAJWIDI, C., S. TABASSUM, and R. GUL. “ASSESSMENT OF INTRAOCULAR PRESSURE FOLLOWING THE INTRAVITREAL INJECTION OF ANTI-VEGF”. International Journal of Current Pharmaceutical Research, vol. 13, no. 5, Sept. 2021, pp. 52-55, doi:10.22159/ijcpr.2021v13i5.1885.



Original Article(s)