TY - JOUR
T1 - Rates of RNFL Thinning in Patients with Suspected or Confirmed Glaucoma Receiving Unilateral Intravitreal Injections for Exudative AMD
AU - Swaminathan, Swarup S.
AU - Kunkler, Anne L.
AU - Quan, Ann V.
AU - Medert, Charles M.
AU - Vanner, Elizabeth A.
AU - Feuer, William
AU - Chang, Ta Chen
N1 - Funding Information:
Funding/Support: Publication of this article was supported by US National Institutes of Health Center Core grant P30EY014801 ; an unrestricted grant from Research to Prevent Blindness ; a 2019 University of Miami Institute for Advanced Study of the Americas Pilot grant; a 2018 Intelligent Research in Sight (IRIS) Registry-American Glaucoma Society (AGS) Research Initiative grant; Miami Clinical and Translational Science Institute grant UL1TR002736; and support from the National Center for Advancing Translational Sciences and the National Institute on Minority Health and Health Disparities . The funding organizations had no role in the design or conduct of this research.
Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. Funding/Support: Publication of this article was supported by US National Institutes of Health Center Core grant P30EY014801; an unrestricted grant from Research to Prevent Blindness; a 2019 University of Miami Institute for Advanced Study of the Americas Pilot grant; a 2018 Intelligent Research in Sight (IRIS) Registry-American Glaucoma Society (AGS) Research Initiative grant; Miami Clinical and Translational Science Institute grant UL1TR002736; and support from the National Center for Advancing Translational Sciences and the National Institute on Minority Health and Health Disparities. The funding organizations had no role in the design or conduct of this research. Financial Disclosures: Swarup Sai Swaminathan is a consultant for Sight Sciences, Ivantis, and Heidelberg Engineering. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. The authors thank Samuel Berchuck, PhD (Duke University) for assistance with the statistical methodologies used in this study.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/6
Y1 - 2021/6
N2 - Purpose: This study evaluated whether the rate of retinal nerve fiber layer (RNFL) thinning is faster in eyes receiving intravitreal injections than in fellow uninjected eyes among patients suspected of having or confirmed to have glaucoma and exudative age-related macular degeneration (AMD). Design: Retrospective comparative cohort study. Methods: Patients with a diagnosis of unilateral exudative AMD and confirmed to have or suspected of having glaucoma in both eyes receiving unilateral intravitreal injections were identified. Those with ≥3 RNFL optical coherence tomography scans and ≥6 injections were included in the study. Rates of RNFL thinning in the injected eye versus the uninjected eye were estimated using linear mixed models. The main outcome measurement was the differences in rates of RNFL thinning in the injected versus the fellow uninjected eye. The effects of postinjection elevation of intraocular pressure (IOP), injection frequency, and number of injections were also evaluated. Results: A total of 53 patients met the inclusion criteria, receiving 26.4 ± 15.9 intravitreal injections. The average rate of RNFL thinning in uninjected eyes was −0.620 μm/year (P = .029). Injected eyes had an additional incremental loss of −0.385 μm/year, but this value was not statistically significant (95% confidence interval [CI]: −1.147 to 0.379 μm/year; P = .324). Subgroup analysis with only glaucoma patients (n = 33) also demonstrated a nonsignificant effect of injections (−0.568 μm/year; 95% CI: −1.454 to 0.319 μm/year; P = .212). Postinjection IOP elevation, injection frequency, and total number of injections were not associated with faster RNFL loss. Conclusions: Among exudative AMD patients with glaucoma or suspected of having glaucoma, the rate of RNFL thinning in eyes receiving intravitreal injections did not significantly differ from that of fellow uninjected eyes.
AB - Purpose: This study evaluated whether the rate of retinal nerve fiber layer (RNFL) thinning is faster in eyes receiving intravitreal injections than in fellow uninjected eyes among patients suspected of having or confirmed to have glaucoma and exudative age-related macular degeneration (AMD). Design: Retrospective comparative cohort study. Methods: Patients with a diagnosis of unilateral exudative AMD and confirmed to have or suspected of having glaucoma in both eyes receiving unilateral intravitreal injections were identified. Those with ≥3 RNFL optical coherence tomography scans and ≥6 injections were included in the study. Rates of RNFL thinning in the injected eye versus the uninjected eye were estimated using linear mixed models. The main outcome measurement was the differences in rates of RNFL thinning in the injected versus the fellow uninjected eye. The effects of postinjection elevation of intraocular pressure (IOP), injection frequency, and number of injections were also evaluated. Results: A total of 53 patients met the inclusion criteria, receiving 26.4 ± 15.9 intravitreal injections. The average rate of RNFL thinning in uninjected eyes was −0.620 μm/year (P = .029). Injected eyes had an additional incremental loss of −0.385 μm/year, but this value was not statistically significant (95% confidence interval [CI]: −1.147 to 0.379 μm/year; P = .324). Subgroup analysis with only glaucoma patients (n = 33) also demonstrated a nonsignificant effect of injections (−0.568 μm/year; 95% CI: −1.454 to 0.319 μm/year; P = .212). Postinjection IOP elevation, injection frequency, and total number of injections were not associated with faster RNFL loss. Conclusions: Among exudative AMD patients with glaucoma or suspected of having glaucoma, the rate of RNFL thinning in eyes receiving intravitreal injections did not significantly differ from that of fellow uninjected eyes.
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U2 - 10.1016/j.ajo.2020.12.016
DO - 10.1016/j.ajo.2020.12.016
M3 - Article
C2 - 33359714
AN - SCOPUS:85103713600
VL - 226
SP - 206
EP - 216
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -