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| Name | Class |
|---|---|
| Dr. Efrem Mandelcorn | UNKNOWN |
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In this study, investigators will be examining the intraocular pressure lowering effect of brimonidine 0.15% when administered 20min prior to intravitreal anti-VEGF injection.
A total of 55 consecutive patients undergoing anti-VEGF intravitreal injections (received ≥1 treatments) for age-related macular degeneration (AMD), diabetic macular edema (DME) or macula edema secondary to branch retinal vein occlusion (BRVO) will be prospectively recruited between December 2016 and July 2017. Patients will be randomly assigned based on a pre-determined allocation sequence to receive topical brimonidine tartrate 0.15% (Alphagan® P; Allergan, Inc) during either the first or second of two consecutive visits. A standard protocol for sterile preparation with topical 5% povidone-iodine solution will be followed. Pre-injection IOP measurements will be recorded prior to the instillation of dilating agents and brimonidine tartrate. A total of three IOP measurements will be taken by certified ophthalmic technicians at immediately after the injection (T0), 10 minutes after (T10) and 20 minutes after (T20) injection.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Brimonidine Pre-Administration During First Visit | Active Comparator |
| |
| Brimonidine Pre-Administration During Second Visit | Active Comparator |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| topical brimonidine tartrate 0.15% (Alphagan® P; Allergan, Inc) | Drug | The rapid hypotensive effects of topical alpha2-agonists such as brimonidine tartrate on decreasing aqueous production and increasing uveoscleral outflow, in addition to their neuroprotective properties, make them an attractive option for prophylactic treatment of post-injection IOP spikes. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Post-Injection Intraocular Pressure Spike | the intraocular pressure lowering effect of brimonidine 0.15% ophthalmic eye drop when administered 20 minutes prior to intravitreal anti-VEGF injection | Change from immediately, 10 minutes and 20 minutes after injection |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Efrem Mandelcorn, MD, FRCSC | University Health Network, Toronto | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26997776 | Background | Kampougeris G, Spyropoulos D, Mitropoulou A. Intraocular Pressure rise after Anti-VEGF Treatment: Prevalence, Possible Mechanisms and Correlations. J Curr Glaucoma Pract. 2013 Jan-Apr;7(1):19-24. doi: 10.5005/jp-journals-10008-1132. Epub 2013 Jan 15. | |
| 24561173 | Background | Kim YJ, Sung KR, Lee KS, Joe SG, Lee JY, Kim JG, Yoon YH. Long-term effects of multiple intravitreal antivascular endothelial growth factor injections on intraocular pressure. Am J Ophthalmol. 2014 Jun;157(6):1266-1271.e1. doi: 10.1016/j.ajo.2014.02.035. Epub 2014 Feb 18. |
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| ID | Term |
|---|---|
| D000068438 | Brimonidine Tartrate |
| ID | Term |
|---|---|
| D011810 | Quinoxalines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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| 22054994 | Background | Hoang QV, Mendonca LS, Della Torre KE, Jung JJ, Tsuang AJ, Freund KB. Effect on intraocular pressure in patients receiving unilateral intravitreal anti-vascular endothelial growth factor injections. Ophthalmology. 2012 Feb;119(2):321-6. doi: 10.1016/j.ophtha.2011.08.011. Epub 2011 Nov 4. |
| 21423038 | Background | Tseng JJ, Vance SK, Della Torre KE, Mendonca LS, Cooney MJ, Klancnik JM, Sorenson JA, Freund KB. Sustained increased intraocular pressure related to intravitreal antivascular endothelial growth factor therapy for neovascular age-related macular degeneration. J Glaucoma. 2012 Apr-May;21(4):241-7. doi: 10.1097/IJG.0b013e31820d7d19. |
| 22249237 | Background | Aref AA. Management of immediate and sustained intraocular pressure rise associated with intravitreal antivascular endothelial growth factor injection therapy. Curr Opin Ophthalmol. 2012 Mar;23(2):105-10. doi: 10.1097/ICU.0b013e32834ff41d. |
| 30573499 | Derived | Felfeli T, Hostovsky A, Trussart R, Yan P, Brent MH, Mandelcorn ED. Hypotensive efficacy of topical brimonidine for intraocular pressure spikes following intravitreal injections of antivascular endothelial growth factor agents: a randomised crossover trial. Br J Ophthalmol. 2019 Oct;103(10):1388-1394. doi: 10.1136/bjophthalmol-2018-312603. Epub 2018 Dec 20. |