Effect of Repeated Intravitreal Injections in Glaucoma Spectrum Diseases

Purpose: To evaluate whether repeated intravitreal injections (IVI) with an anti-vascular endothelial growth factor (anti-VEGF) agent are associated with glaucomatous progression in eyes with glaucoma spectrum diseases (GSD). Methods: Single-center, retrospective, longitudinal study of patients with bilateral and similar GSD who: (1) received [greater than or equal to] 8 IVI in only one eye during the study period; (2) had [greater than or equal to] 2 retinal nerve fiber layer thickness (RNFL) measurements obtained by spectral-domain optical coherence tomography (SD-OCT) at least 12 months apart. The primary outcome was the absolute RNFL thickness change, comparing injected and fellow uninjected eyes. Linear mixed effects models were constructed, including a multivariable model. Results: Sixty-eight eyes from 34 patients were included, 34 injected and 34 fellow uninjected eyes. Average baseline age was 67.68 [+ or -] 21.77 years with a follow-up of 3.66 [+ or -] 1.89 years and 25.12 [+ or -] 14.49 IVI. RNFL thickness decreased significantly from 80.92 [+ or -] 15.78 to 77.20 [+ or -] 17.35 [micro]m (p