目的:前瞻性评估玻璃体腔内注射兰尼单抗、2和4mg曲安奈德(TA)后眼压(IOP)的即时变化。方法:接受玻璃体腔内注射0.1mL(4mg)曲安奈德(T4组),0.05mL(2mg)TA(T2组)和0.05mL(0.5mg)兰尼单抗(R组)的患者组成研究群体。总体而言,205例229眼接受注射。T4组54眼(23.6%),T2组69眼(30.1%),及R组106眼(46.3%)。如果注射后即时眼压<26mmHg就不行进一步的测量。如果眼压≥26mmHg,就在5,15和30min后重新测量眼压,直到读数<26mmHg。结果:注射后即时眼压,T4组28眼(51.9%),T2组22眼(31.9%)和R组51眼(48.1%)超过25mmHg。到30min时,T4组1眼(1.9%),T2组2眼(2.9%)和R组2眼(1.9%),眼压超过25mmHg。T4组和R组注射后即时眼压显著高于T2组(P<0.01和P<0.01)。各组中无玻璃体回流眼的眼压显著高于有玻璃体回流眼(P<0.01)。结论:玻璃体腔内注射2或4mg曲安奈德和0.5mg的兰尼单抗后眼压可能会立即显著提高。无玻璃体回流是注射后眼压即时上升的最重要的预测因素。

AIM: To evaluate prospectively immediate intraocular pressure (IOP) changes after the intravitreal injection of ranibizumab, 2 and 4mg triamcinolone acetonide. METHODS: Patients who underwent intravitreal injection of 0.1mL (4mg) triamcinolone acetonide (TA, Group T4), 0.05mL (2mg) TA (Group T2) and 0.05mL (0.5mg) ranibizumab (Group R) comprised the study population. Overall, 229 eyes of 205 patients were injected. Fifty-four eyes (23.6%) were in Group T4, 69 eyes (30.1%) in Group T2 and 106 eyes (46.3%) in Group R. If IOP was less than 26mmHg immediately after the injection no further measurement was performed. If IOP was ≥26mmHg, IOP was remeasured till the reading was below 26mmHg at 5, 15 and 30 minutes. RESULTS: Immediately after the injection, the IOP of 28 eyes (51.9%) in Group T4, 22 eyes (31.9%) in Group T2 and 51 eyes (48.1%) in Group R were over 25mmHg. At 30 minutes, IOP of one eye (1.9%) in group T4, two eyes (2.9%) in group T2 and two eyes (1.9 %) in Group R were over 25mmHg. Immediate post-injection IOP was significantly higher in Group T4 and Group R when compared to Group T2(P<0.001 and P<0.001,respectively). IOP was significantly higher in eyes without vitreous reflux when compared to those with vitreous reflux in all groups (P<0.001). CONCLUSION: IOP may remarkably increase immediately after the intravitreal injection of 2 or 4mg triamcinolone acetonide, and 0.5mg ranibizumab. Absence of vitreous reflux is the most important predicting factor for immediate IOP rise after the injection.

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