Immediate changes in blood pressure during intravitreal anti-VEGF agents' applications in exudative age-related macular degeneration patients

• DOI: 10.1007/s10792-020-01431-3
• Publication Date: 2020-06-03T15:59:11Z
• Authors: Sevcan Balci; Ozlem Sahin; Sehnaz Ozcaliskan; Mehmet Orkun Sevik; Mehmet Serhat Mangan
• Keywords: Vascular Endothelial Growth Factor A; Angiogenesis Inhibitors; Blood Pressure; Antibodies, Monoclonal, Humanized; 3. Good health; Bevacizumab; Macular Degeneration; 03 medical and health sciences; 0302 clinical medicine; Ranibizumab; Intravitreal Injections; Wet Macular Degeneration; Humans; Retrospective Studies

To determine the short-term changes in systemic arterial blood pressure (SABP) during intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection in patients with exudative age-related macular degeneration (ARMD).This study retrospectively reviewed the data of 550 patients with exudative ARMD, who received intravitreal anti-VEGF (bevacizumab or ranibizumab; selected randomly) injections. Patients with hypertension on medication with antihypertensive drugs were assigned to the hypertension group (HTG; n = 278); those with normal blood pressure and not on antihypertensive drugs were assigned to the normotensive group (NTG; n = 272). The SABP levels were measured 30 min before anti-VEGF injection (baseline = B), during anti-VEGF injection (DI), as well as 30th (I30) and 60th (I60) min after anti-VEGF injection.Both groups had significantly higher systolic blood pressure (SBP) at DI than that of the baseline values (p < 0.001), whereas the diastolic blood pressures (DBP) increased significantly at DI, I30, and I60 compared with baseline (p < 0.001). In NTG, SBP was significantly higher in patients at I30 (p = 0.019), whereas that in HTG was significantly higher at all measurements (p < 0.05) only in patients who received intravitreal bevacizumab injection.Our study results show that intravitreal anti-VEGF injection is associated with a short-term increase in SABP. To prevent potential systemic complications during anti-VEGF administration, the systemic status of patients with ARMD should be evaluated before the injection and those with a risk of high SABP during injection should be closely monitored.