Research Article: Selective laser trabeculoplasty for anti-VEGF associated intraocular pressure elevation in steroid-naïve eyes
Abstract:
Selective Laser Trabeculoplasty (SLT) is utilized in cases of primary and certain secondary open-angle glaucoma to decrease intraocular pressure (IOP). SLT effectiveness has been demonstrated in patients with increased IOP secondary to intraocular steroids. In addition to intravitreal steroids, intravitreal anti-vascular endothelial growth factor (VEGF) injections are commonly used in patients with diabetic retinopathy and age-related macular degeneration. Some patients receiving anti-VEGF injections experience increases in IOP. No studies have evaluated the effectiveness of SLT for anti-VEGF-associated glaucoma.
This was a retrospective, single-center study. Anti-VEGF-associated IOP increase was defined as an eye receiving at least one anti-VEGF intravitreal injection prior to SLT. IOP and the number of pressure-lowering drops were measured at 3-, 6-, 9-, and 12-month post-SLT follow-up appointments. Outcomes included changes in IOP, and the number of IOP-lowering drops prescribed.
Twenty-three eyes from 18 patients were included in this study. The IOP was 18.26 ± 3.33 with 2.6 ± 1. drops prescribed at baseline. Two eyes required repeat SLT. Over the study period, IOP was reduced by 3 to 4.5 mm Hg, with all p-values <0.001. Eight eyes in the study were drop-naïve (no IOP-lowering drops prescribed prior to SLT). Of these, 6/8 (75%) remained drop-free at the end of the observation period. At their final clinic visit, 78.3% of patients were controlled on SLT without further surgical or medical intervention.
To the best of our knowledge, this is the first study to demonstrate the long-term effectiveness of SLT in anti-VEGF-associated open-angle glaucoma in steroid-naïve eyes.
Introduction:
Selective Laser Trabeculoplasty (SLT) is used in primary and certain secondary open-angle glaucoma (OAG) cases to increase aqueous humor outflow and thereby decrease intraocular pressure (IOP). SLT has been shown to reduce IOP by an average of 22% at 6 months and 32% at 5 years post-SLT ( 1 , 2 ). According to the LiGHT trial, SLT is an effective alternative to IOP-lowering drops in open-angle glaucoma patients ( 2 , 3 ). Due to its favorable safety profile and cost effectiveness, SLT is a valid treatment option…
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