Background
To describe the occurrence of ocular hypertension in four patients following injection of ranibizumab intravitreally.
Results
Four patients had high intraocular pressure after intravitreal ranibizumab 0.5 mg. Ocular hypertension occurred 1 month after
the second ranibizumab injection in patients 1 and 3, and 1 month after the first ranibizumab in patient 2. In patient 4,
it occurred several hours after the first ranibizumab injection. In all patients, the IOP increase was sustained across several
visits, requiring control with topical glaucoma therapy, and in two cases the addition of a systemic carbonic anhydrase inhibitor.
None of the patients had a previous history of glaucoma, ocular hypertension or IOP asymmetry and the IOP was as high as 30,
34, 46, and 50 mmHg in the four patients.
Conclusion
Severe and sustained ocular hypertension may occur after intravitreal ranibizumab. Although the mechanism of the pressure
rise is unknown, all eyes in our series were controlled with medical therapy.
Keywords Intraocular pressure - Ranibizumab - Intravitreal - Lucentis - Intravitreal - Ocular hypertension - Glaucoma - Pressure increase - Anti-VEGF
Supported in part by an unrestricted departmental grant from Research to Prevent Blindness, New York, NY, USA