Exploring the Relationship between Anti-VEGF Therapy and Glaucoma: Implications for Management Strategies

A short-term increase in intraocular pressure (IOP) is a common side effect after intravitreal anti-VEGF therapy, but a sustained increase in IOP with the development of secondary glaucoma has also been reported in some studies after repeated intravitreal anti-VEGF injections. The aim of this review is to present and discuss the possible pathophysiological mechanisms and factors contributing to a sustained rise in IOP, as well as treatment strategies for patients at risk. Close monitoring and adjustable IOP-lowering treatment are recommended for high-risk patients, including those with glaucoma, angle-closure anomalies, ocular hypertension or family history of glaucoma; patients receiving a high number of injections or at shorter intervals; and patients with capsulotomy. Strategies are needed to identify patients at risk in a timely manner and to prevent sustained elevation of IOP.

Automated summary

A short-term increase in intraocular pressure is a common side effect of intravitreal anti-VEGF therapy, but some studies have reported sustained elevation of IOP and development of secondary glaucoma after repeated injections. This review focuses on discussing the possible mechanisms and risk factors contributing to sustained rise in IOP, as well as suggesting treatment strategies for high-risk patients. Close monitoring and adjustable IOP-lowering treatment are recommended to prevent sustained elevation of IOP in these patients.