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Observational Study
. 2025 Apr 22;109(5):600-605.
doi: 10.1136/bjo-2024-326053.

Short-term intraocular pressure changes after intravitreal aflibercept 2 mg, aflibercept 8 mg and faricimab: a prospective, comparative study

Arianna Paris  1 , Giulio Volpe  1 , Kathrin Perruchoud-Ader  1 , Alex Casanova  1 , Moreno Menghini  1 , Gabriela Grimaldi  2
Affiliations
Observational Study

Short-term intraocular pressure changes after intravitreal aflibercept 2 mg, aflibercept 8 mg and faricimab: a prospective, comparative study

Arianna Paris et al. Br J Ophthalmol. .

Abstract

Background/aims: Intravitreal injection (IVT) of anti-vascular endothelial growth factor agents is the standard of care for several retinal diseases but can cause intraocular pressure (IOP) elevations. This study investigates short-term postinjection IOP changes following aflibercept 8 mg and faricimab, compared with aflibercept 2 mg.

Methods: This observational, prospective study included 90 patients with age-related macular degeneration or diabetic macular oedema, divided into three groups, receiving aflibercept 2 mg, aflibercept 8 mg or faricimab. IOP was measured using an iCare IC200-tonometer preinjection (T0) and at 30 s (T1), 5 min (T2) and 15 min (T3) postinjection. Primary outcomes included IOP changes at the four time points within and between treatment groups. The incidence of transient visual loss requiring paracentesis was recorded.

Results: All groups experienced a significant IOP increase at T1, with mean IOP increase being 41.47±12.95 mm Hg for aflibercept 2 mg, 43.46±8.97 mm Hg for aflibercept 8 mg and 32.19±11.06 mm Hg for faricimab. By T2, IOP differences were not significant, and by T3, mean IOP returned within normal limits across all groups. Faricimab showed a smaller initial IOP spike than both aflibercept formulations, but this difference was not statistically significant at T2 and T3.

Conclusion: Transient IOP spikes are observed post-IVT of aflibercept 8 mg and faricimab, with similar trends to aflibercept 2 mg. The initial IOP elevation normalised within 15 min. Faricimab had a lower initial spike, but overall IOP profiles were comparable across different agents.

Keywords: Age-Related Macular Degeneration; Intraocular pressure; Retina; Vascular Endothelial Growth Factor.

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Conflict of interest statement

Competing interests: AC provided consulting and/or speaker services for Santen. GG provided consulting and/or speaker services for Abbvie, Apellis, Bayer and Roche. MM provided consulting and/or speaker services for Abbvie, Apellis, Bayer, Novartis, Roche, and he is consultant and holds equity of Endogena.This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. All authors received an unrestricted grant from Bayer AG Switzerland, intended to support research activities at their hospital in a broader sense.

Figures

Figure 1
Figure 1. Comparison of mean intraocular pressure across different time points between treatment groups. T0=prior to injection; T1=30 s after injection; T2=5 min after injection; T3=15 min after injection. *Significant difference (p<0.001) for comparison with other treatments at the same time point.
See this image and copyright information in PMC

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