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Klin Monbl Augenheilkd 2023; 240(04): 478-480
DOI: 10.1055/a-2004-5664
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Rapidly Progressive Visual Field Deterioration in a Glaucomatous Patient Treated with Several Anti-VEGF Injections for Neovascular AMD: A Case Report

Rasch fortschreitende Gesichtsfeldverschlechterung bei einem Glaukompatienten, der mit mehreren Anti-VEGF-Injektionen gegen neovaskuläre AMD behandelt wurde: ein Fallbericht
Coraline Calci
1   Ophthalmology, Swiss Visio Montchoisi – Centre B Lausanne, CH, Lausanne, Switzerland
,
Daniela Gallo Castro
2   Ophthalmology, Swiss Visio Retina Research, Center, Lausanne, Switzerland
,
Yannic Pannatier Schuetz
2   Ophthalmology, Swiss Visio Retina Research, Center, Lausanne, Switzerland
,
André Mermoud
1   Ophthalmology, Swiss Visio Montchoisi – Centre B Lausanne, CH, Lausanne, Switzerland
3   Ophthalmology, Swiss Glaucoma Research Fondation, Lausanne, Switzerland
,
Aude Ambresin
1   Ophthalmology, Swiss Visio Montchoisi – Centre B Lausanne, CH, Lausanne, Switzerland
2   Ophthalmology, Swiss Visio Retina Research, Center, Lausanne, Switzerland
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Introduction

Intravitreal anti-vascular endothelial growth factor (VEGF) agents have revolutionized, and are now the mainstay of treatment for neovascular age-related macular degeneration (AMD) [1], [2], [3].

Although widely used, due to their efficacy, they are not entirely without risks.

One of the recognized side effects of intravitreal anti-VEGF injections (IVIs) is the elevation of intraocular pressure (IOP) [4], [5], [6]. Although transient and related mainly to an increase in intraocular volume, the increase of IOP has a negative effect on changes in the thickness of the peripapillary nerve fiber layer [7], [8] and seems to be more deleterious in glaucoma patients who already show optic nerve damage and in which IOP spikes take longer to return to basal levels (where normal IOP values are considered between 10 and 21 mmHg) [9]. Moreover, an increase in IOP following IVI is associated with a significant reduction in optic nerve perfusion [10], [11].

Up to the present, there have been no reports of visual field (VF) degradation related to an increase in IOP following repeated intravitreal injections. The purpose of this report is to show the correlation between acute increases in IOP after IVIs and VF loss, especially in glaucomatous patients.



Publication History

Received: 17 October 2022

Accepted: 13 December 2022

Article published online:
25 April 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
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