Post-Injection Intraocular Pressure Spikes
Conditions
Keywords
Intraocular Pressure, Anti-VEGF Agents, alpha2-agonists
Brief summary
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.
Detailed description
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.
Interventions
DRUGtopical brimonidine tartrate 0.15% (Alphagan® P; Allergan, Inc)
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.
Sponsors
Dr. Efrem Mandelcorn
University of Toronto
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* received ≥1 treatments for age-related macular degeneration (AMD), diabetic macular edema (DME) or macula edema secondary to branch retinal vein occlusion (BRVO)
Exclusion criteria
* baseline diagnosis of glaucoma * baseline IOP during last visit of greater than 21 mmHg * ongoing use of topical medications (eg. corticosteroids) * pseudophakic with an anterior chamber intraocular lens * history of ocular conditions that may impact IOP (eg. pseudoexfoliation) * previous in-office (eg. laser peripheral iridotomy) and vitreoretinal surgical procedures (eg. pars plana vitrectomy).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Post-Injection Intraocular Pressure Spike | Change from immediately, 10 minutes and 20 minutes after injection | the intraocular pressure lowering effect of brimonidine 0.15% ophthalmic eye drop when administered 20 minutes prior to intravitreal anti-VEGF injection |
Outcome results
None listed