A prospective study of blood pressure and intraocular pressure changes in hypertensive and nonhypertensive patients after intravitreal bevacizumab injection.

Abstract

To evaluate the changes in blood pressure and intraocular pressure (IOP) in patients with and without hypertension after intravitreal bevacizumab (Avastin) injection. This study examined 135 (74 nonhypertensive vs. 61 hypertensive) consecutive patients treated with an intravitreal injection of 1.25 mg bevacizumab for retinal vascular diseases prospectively over a 6-month period. All the hypertensive patients were on medication, and only patients with controlled hypertension after consultation with cardiology specialists were included. Intraocular pressure and blood pressure were measured before and 30 minutes, 1 day, 1 week, 3 weeks, and then every month after the bevacizumab injection. The mean baseline systolic and diastolic pressures were significantly higher in the hypertensive group (systolic P = 0.001, diastolic P = 0.023). None of the systolic and diastolic values after injection differed significantly from the baseline values in the hypertensive group. By contrast, the 30-minute systolic values were significantly higher than baseline (P < 0.05), and the 1-day diastolic values were lower than before injection in the nonhypertensive group (P < 0.05). The mean baseline IOP of the nonhypertensive and hypertensive groups was similar (P = 0.08). The mean IOP 30 minutes after injection was significantly higher than the baseline mean IOP (P < 0.05), and the mean IOPs at 1 day and 1 week were significantly lower than before injection in both groups (P < 0.05). Intravitreal bevacizumab injection is safe in terms of blood pressure and IOP in both hypertensive and nonhypertensive patients after 6 months of follow-up.