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To assess the effect of prophylactic antiglaucoma agents in prevention of acute intraocular pressure rise after intravitreal injection.
Acute intraocular pressure elevation after intravitreal injection of bevacizumab was proven.Acute intraocular pressure elevation most probably is volume related and long term intraocular pressure elevation relates to pharmacologic features of the medications which results in anatomic changes in the angle of anterior chamber.Numerous studies found an intraocular pressure elevation right after the injection and quick normalization within maximally 30 minutes.This intraocular pressure elevation which lasts about 30 minutes, can result in irreversible visual loss especially in patients with critical remaining nerve fibers in the optic nerve head, as occurs in glaucomatous patients. Is there any way to prevent or even shorten this time of intraocular pressure elevation? We tried in our study to find a suitable response for a question above, so we used several anti-glaucoma agents (Timolol, Brimonidine, Acetazolamide, Mannitol versus placebo) as a prophylaxis to prevent acute intraocular pressure elevation right after intravitreal bevacizumab injection.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Timolol | Active Comparator | Timolol eyedrop, 2 drops 5 minutes apart, 1-2 hours before intravitreal injection |
|
| Brimonidine | Active Comparator | Brimonidine eyedrop, 2 drops 5 minutes apart, 1-2 hours before intravitreal injection |
|
| Acetazolamide | Active Comparator | Acetazolamide tablet, 2 tabs, 2 hours before intravitreal injection |
|
| Mannitol | Active Comparator | Intravenous mannitol, 1.5 gram/kg, 1 hour before intravitreal injection |
|
| Placebo | Sham Comparator | Artificial tears, 2 drops, 1-2 hours before intravitreal injection |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Timolol | Drug | 2 drops of timolol, 10 minutes apart, 1-2 hours before intravitreal injection |
|
| Measure | Description | Time Frame |
|---|---|---|
| change in IOP | the change in intraocular pressure after intravitreal injection of bevacizumab | 0, 5, 10, 15, 30 minutes after injection |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nasser Shoeibi, M.D. | Retina Research Center, Mashhad University of Medical Sciences, Mashhad, Iran | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Retina Research Center, Khatam eye Hospital | Mashhad | Razavi Khorasan Province | Iran |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33389369 | Derived | Shoeibi N, Ghosi Z, Jafari H, Omidtabrizi A. Effect of antiglaucoma agents on short-term intraocular pressure fluctuations after intravitreal bevacizumab injections. Int Ophthalmol. 2021 Mar;41(3):1081-1090. doi: 10.1007/s10792-020-01667-z. Epub 2021 Jan 2. |
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| Brimonidine | Drug | Brimonidine eyedrop, 2 drops 5 minutes apart, 1-2 hours before intravitreal injection |
|
|
| Acetazolamide | Drug | Acetazolamide tablet, 2 tabs, 2 hours before intravitreal injection |
|
|
| Mannitol | Drug | Intravenous mannitol, 1.5 gram/kg, 1 hour before intravitreal injection |
|
| Placebo | Drug | Artificial tears, 2 drops, 1-2 hours before intravitreal injection |
|
|
| ID | Term |
|---|---|
| D013999 | Timolol |
| D000068438 | Brimonidine Tartrate |
| D000086 | Acetazolamide |
| D008353 | Mannitol |
| C005703 | salicylhydroxamic acid |
| ID | Term |
|---|---|
| D011412 | Propanolamines |
| D000605 | Amino Alcohols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D020005 | Propanols |
| D000588 | Amines |
| D013830 | Thiadiazoles |
| D013844 | Thiazoles |
| D013457 | Sulfur Compounds |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D009025 | Morpholines |
| D010078 | Oxazines |
| D011810 | Quinoxalines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D013402 | Sugar Alcohols |
| D002241 | Carbohydrates |
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