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Intraocular Pressure Effects of Pegaptanib (Macugen) Injections in Patients With and Without Glaucoma
similar result as our article.5 This fact may also support the relevance of our study. In conclusion, our measurement method of tear meniscus height noninvasively also is useful as their tear meniscus curvature measurement. ATSURO UCHIDA MIKI UCHINO EIKI GOTO ERI HOSAKA YUKO KASUYA KAZUMI FUKAGAWA MURAT DOGRU YOKO OGAWA KAZUO TSUBOTA
Tokyo, Japan
REFERENCES
1. Uchida A, Uchino M, Goto E, et al. Noninvasive interference tear meniscometry in dry eye patients with Sjögren syndrome. Am J Ophthalmol 2007;144:232–237. 2. King-Smith PE, Fink BA, Fogt N, Nichols KK, Hill RM, Wilson GS. The thickness of the human precorneal tear-film: evidence from reflection spectra. Invest Ophthalmol Vis Sci 2000;41:3348 –3359. 3. Creech JL, Do LT, Fatt I, Radke CJ. In vivo tear-film thickness determination and implications for tear-film stability. Curr Eye Res 1998;17:1058 –1066. 4. Oguz H, Yokoi N, Kinoshita S. The height and radius of the tear meniscus and methods for examining these parameters. Cornea 2000;19:497–500. 5. Savini G, Barboni P, Zanini M. Tear meniscus evaluation by optical coherence tomography. Ophthalmic Surg Lasers Imaging 2006;37:112–118.
attributable to the fact that similar trabecular outflow compromise as the one seen in glaucomatous eyes is present in most study patients due to the advanced age of the patients receiving Macugen. We would like to draw their attention to an article published by our group recently.4 We also noted the effect mentioned by Frenkel and associates and developed a biomechanical model linking the pressure increase to axial length of the respective eye. Our model was well matched by our experimental data measured in patients receiving 0.1 ml intravitreal triamcinolone. This means that the highest immediate postoperative pressure was measured in the shorter eyes. We would be interested to know whether this holds true in the group evaluated by Frenkel and associates. Therefore, we suggest that the authors divide their patient groups according to axial length and re-analyze their data according to that parameter. We would like to express that it is necessary to be aware of the fact of dramatically increased IOP following intravitreal injections especially in short eyes and patients prone to vascular compromise. We congratulate Frenkel and associates on their well designed study and their publication. During the publication process of our above mentioned study, we had quite a few negative experiences in the review process of different journals with editorial comments pointing out that the effect is negligible since transitory. Of course, the added risk of a paracentesis to lower the IOP has always to be taken into account, however, we think that IOP spikes to levels higher than 55 mm Hg (mean value in our study using Schiötz tonometry) also poses a real risk in hyperopic and vascularly compromised eyes. INES M. LANZL MATHIAS MAIER NIKOLAUS FEUCHT
Intraocular Pressure Effects of Pegaptanib (Macugen) Injections in Patients With and Without Glaucoma
CHRIS P. LOHMANN KONSTANTIN E. KOTLIAR
Munich, Germany
EDITOR: WE READ WITH INTEREST THE RECENT ARTICLE BY FRENKEL
REFERENCES
and associates titled “Intraocular Pressure Effects of Pegaptanib (Macugen) Injections in Patients With and Without Glaucoma”.1 They measure the immediate intraocular pressure (IOP) rise following intravitreal injections and should be congratulated for bringing this often overseen effect to the reader’s attention. In usual clinical practice as mentioned by Frenkel and associates, the pressure is evaluated depending on the observer at the earliest 30 minutes up to days after the injection.2,3 The short-term effect, brought by the sheer increase in volume, is therefore missed by most observers. Frenkel and associates noted that in their patient group the ones with and without glaucoma showed a similar rate of IOP normalization over time. Of course, this could be
1. Frenkel RE, Mani L, Toler AR, Frenkel MP. Intraocular pressure effects of pegaptanib (Macugen) injections in patients with and without glaucoma. Am J Ophthalmol 2007;143: 1034 –1035. 2. Lee EW, Hariprasad SM, Mieler WF, Newman TL, Apte RS. Short-term intraocular pressure trends after intravitreal triamcinolone injection. Am J Ophthalmol 2007;143:365–367. 3. Hariprasad SM, Shah GK, Blinder KJ. Short-term intraocular pressure trends following intravitreal pegaptanib (Macugen) injection. Am J Ophthalmol 2006;141:200 –201. 4. Kotliar K, Maier M, Bauer S, Feucht N, Lohmann C, Lanzl I. Effect of intravitreal injections and volume changes on intraocular pressure: clinical results and biomechanical model. Acta Ophthalmol Scand 2007. Forthcoming.
VOL. 145, NO. 1
CORRESPONDENCE
185
Tokyo, Japan
REFERENCES
1. Uchida A, Uchino M, Goto E, et al. Noninvasive interference tear meniscometry in dry eye patients with Sjögren syndrome. Am J Ophthalmol 2007;144:232–237. 2. King-Smith PE, Fink BA, Fogt N, Nichols KK, Hill RM, Wilson GS. The thickness of the human precorneal tear-film: evidence from reflection spectra. Invest Ophthalmol Vis Sci 2000;41:3348 –3359. 3. Creech JL, Do LT, Fatt I, Radke CJ. In vivo tear-film thickness determination and implications for tear-film stability. Curr Eye Res 1998;17:1058 –1066. 4. Oguz H, Yokoi N, Kinoshita S. The height and radius of the tear meniscus and methods for examining these parameters. Cornea 2000;19:497–500. 5. Savini G, Barboni P, Zanini M. Tear meniscus evaluation by optical coherence tomography. Ophthalmic Surg Lasers Imaging 2006;37:112–118.
attributable to the fact that similar trabecular outflow compromise as the one seen in glaucomatous eyes is present in most study patients due to the advanced age of the patients receiving Macugen. We would like to draw their attention to an article published by our group recently.4 We also noted the effect mentioned by Frenkel and associates and developed a biomechanical model linking the pressure increase to axial length of the respective eye. Our model was well matched by our experimental data measured in patients receiving 0.1 ml intravitreal triamcinolone. This means that the highest immediate postoperative pressure was measured in the shorter eyes. We would be interested to know whether this holds true in the group evaluated by Frenkel and associates. Therefore, we suggest that the authors divide their patient groups according to axial length and re-analyze their data according to that parameter. We would like to express that it is necessary to be aware of the fact of dramatically increased IOP following intravitreal injections especially in short eyes and patients prone to vascular compromise. We congratulate Frenkel and associates on their well designed study and their publication. During the publication process of our above mentioned study, we had quite a few negative experiences in the review process of different journals with editorial comments pointing out that the effect is negligible since transitory. Of course, the added risk of a paracentesis to lower the IOP has always to be taken into account, however, we think that IOP spikes to levels higher than 55 mm Hg (mean value in our study using Schiötz tonometry) also poses a real risk in hyperopic and vascularly compromised eyes. INES M. LANZL MATHIAS MAIER NIKOLAUS FEUCHT
Intraocular Pressure Effects of Pegaptanib (Macugen) Injections in Patients With and Without Glaucoma
CHRIS P. LOHMANN KONSTANTIN E. KOTLIAR
Munich, Germany
EDITOR: WE READ WITH INTEREST THE RECENT ARTICLE BY FRENKEL
REFERENCES
and associates titled “Intraocular Pressure Effects of Pegaptanib (Macugen) Injections in Patients With and Without Glaucoma”.1 They measure the immediate intraocular pressure (IOP) rise following intravitreal injections and should be congratulated for bringing this often overseen effect to the reader’s attention. In usual clinical practice as mentioned by Frenkel and associates, the pressure is evaluated depending on the observer at the earliest 30 minutes up to days after the injection.2,3 The short-term effect, brought by the sheer increase in volume, is therefore missed by most observers. Frenkel and associates noted that in their patient group the ones with and without glaucoma showed a similar rate of IOP normalization over time. Of course, this could be
1. Frenkel RE, Mani L, Toler AR, Frenkel MP. Intraocular pressure effects of pegaptanib (Macugen) injections in patients with and without glaucoma. Am J Ophthalmol 2007;143: 1034 –1035. 2. Lee EW, Hariprasad SM, Mieler WF, Newman TL, Apte RS. Short-term intraocular pressure trends after intravitreal triamcinolone injection. Am J Ophthalmol 2007;143:365–367. 3. Hariprasad SM, Shah GK, Blinder KJ. Short-term intraocular pressure trends following intravitreal pegaptanib (Macugen) injection. Am J Ophthalmol 2006;141:200 –201. 4. Kotliar K, Maier M, Bauer S, Feucht N, Lohmann C, Lanzl I. Effect of intravitreal injections and volume changes on intraocular pressure: clinical results and biomechanical model. Acta Ophthalmol Scand 2007. Forthcoming.
VOL. 145, NO. 1
CORRESPONDENCE
185