Changes in intraocular pressure in study and fellow eyes in the IVAN trial


PURPOSE: To describe changes in intraocular pressure (IOP) in the 'alternative treatments to Inhibit VEGF in Age-related choroidal Neovascularisation (IVAN)' trial (registered as ISRCTN92166560). DESIGN: Randomised controlled clinical trial with factorial design. PARTICIPANTS: Patients (n=610) with treatment naïve neovascular age-related macular degeneration were enrolled and randomly assigned to receive either ranibizumab or bevacizumab and to two regimens, namely monthly (continuous) or as needed (discontinuous) treatment. METHODS: At monthly visits, IOP was measured preinjection in both eyes, and postinjection in the study eye. OUTCOME MEASURES: The effects of 10 prespecified covariates on preinjection IOP, change in IOP (postinjection minus preinjection) and the difference in preinjection IOP between the two eyes were examined. RESULTS: For every month in trial, there was a statistically significant rise in both the preinjection IOP and the change in IOP postinjection during the time in the trial (estimate 0.02 mm Hg, 95% CI 0.01 to 0.03, p<0.001 and 0.03 mm Hg, 95% CI 0.01 to 0.04, p=0.002, respectively). There was also a small but significant increase during the time in trial in the difference in IOP between the two eyes (estimate 0.01 mm Hg, 95% CI 0.005 to 0.02, p<0.001). There were no differences between bevacizumab and ranibizumab for any of the three outcomes (p=0.93, p=0.22 and p=0.87, respectively). CONCLUSIONS: Anti-vascular endothelial growth factor agents induce increases in IOP of small and uncertain clinical significance.

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Divisions: College of Health & Life Sciences > School of Optometry > Optometry & Vision Science Research Group (OVSRG)
College of Health & Life Sciences
College of Health & Life Sciences > School of Optometry > Vision, Hearing and Language
College of Health & Life Sciences > School of Optometry > Optometry
Additional Information: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Uncontrolled Keywords: Ophthalmology,Sensory Systems,Cellular and Molecular Neuroscience
Publication ISSN: 1468-2079
Last Modified: 12 Feb 2024 08:09
Date Deposited: 05 May 2016 13:39
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Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
http://bjo.bmj. ... mol-2015-307595 (Publisher URL)
PURE Output Type: Article
Published Date: 2016-11-22
Published Online Date: 2016-04-12
Accepted Date: 2016-02-22
Submitted Date: 2015-08-16
Authors: Foss, Alexander J.E.
Scott, Lauren J.
Rogers, Chris A.
Reeves, Barney C.
Ghanchi, Faruque
Gibson, Jonathan (ORCID Profile 0000-0002-9281-5244)
Chakravarthy, Usha
, IVAN study group


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