Intraocular pressure, increased intravitreal injection

In 150 patients who were given intravitreous fomivirsen 165 micrograms/injection (35 eyes, 30 patients) or two different regimens of 330 micrograms/injection (142 eyes, 110 patients), anterior chamber inflammation and increased intraocular pressure were dose-related and schedule-dependent 165 micrograms/injection, 4.1... 

Intravitreal injections to deliver corticosteroids minimize systemic side effects however, they may be associated with complications such as retinal detachment, retinal tears, vitreous hemorrhage, endophthalmitis, increased intraocular pressure (IOP), cataract formation, and, with repeated use (required for successful treatment), fibrosis and ptosis. The most common side effect is increased IOP, which has been found on rare occasion to increase drastically (up to 50mmHg in one case report by Detry-Morel et al.) (16,34,35). Close IOP monitoring is crucial following intravitreal injection. 

The series of clinical trials that led to approval by the U.S. Food and Drug Administration involved 430 eyes in 330 patients. Fomivirsen significantly delayed progression of CMV retinitis in patients with AIDS, including those who had failed treatment with ganciclovir or foscarnet, the first-line therapies. Fomivirsen is administered by intravitreal injection at doses of 165 pg once weekly for three weeks of induction and then once every two weeks. It also can be administered In a dose of 330 pg on days 1 and 15 and then once a month thereafter. Mean maximum retinal concentrations of fomivirsen occur at 2 days, and the elimination half-life after a single, 115-pg dose in monkey retina was 78 hours. There are no systemic side effects. Ocular side effects include Increased intraocular pressure and mild to moderate intraocular inflammation that can be reversed with topical steroid treatment. It is important that side effects be minor, because treatment will be lifelong. 

Sensory systems Eyes A transient increase in intraocular pressure has also been reported 0-30 minutes after intravitreal injections. In one study intraocular pressure rose as early as 5 seconds after intravenous injection of ranibizumab [11 ]. The mean pressure after 5 seconds was 44 (range 22-59) mmHg it was higher in eyes with shorter axial lengths. 

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